Provider Demographics
NPI:1366507915
Name:HAWK, VIRGINIA (CNM)
Entity Type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:
Last Name:HAWK
Suffix:
Gender:F
Credentials:CNM
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2398 MOUNT VERNON RD
Mailing Address - Street 2:SUITE 150
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-3064
Mailing Address - Country:US
Mailing Address - Phone:770-512-7099
Mailing Address - Fax:770-512-7090
Practice Address - Street 1:2398 MOUNT VERNON RD
Practice Address - Street 2:SUITE 150
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-3064
Practice Address - Country:US
Practice Address - Phone:770-512-7099
Practice Address - Fax:770-512-7090
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2011-08-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN048204367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00800137AMedicaid
GA00800137BMedicaid