Provider Demographics
NPI:1376021972
Name:HAWES, CAROLINE WITT (PA-C)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:WITT
Last Name:HAWES
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6912 WOODSTOCK DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28210-6541
Mailing Address - Country:US
Mailing Address - Phone:276-356-8070
Mailing Address - Fax:
Practice Address - Street 1:901 E 4TH ST STE D
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28204-2622
Practice Address - Country:US
Practice Address - Phone:980-202-6526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-06
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-08482363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant