Provider Demographics
NPI:1518748375
Name:HAWK, JAMES OWEN (BSN, RN (NP STUDENT))
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:OWEN
Last Name:HAWK
Suffix:
Gender:M
Credentials:BSN, RN (NP STUDENT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2368 RIDGE TRL
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-3758
Mailing Address - Country:US
Mailing Address - Phone:256-630-2542
Mailing Address - Fax:
Practice Address - Street 1:1700 6TH AVE S RM 8284
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1802
Practice Address - Country:US
Practice Address - Phone:205-996-6921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-09
Last Update Date:2023-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-151809163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology