Provider Demographics
NPI:1538141007
Name:HAWKINS, ANGELA M (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:M
Last Name:HAWKINS
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 1:580 SAINT JOHNSBURY RD
Mailing Address - Street 2:SUITE K
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-3437
Mailing Address - Country:US
Mailing Address - Phone:603-444-2010
Mailing Address - Fax:603-444-2181
Practice Address - Street 1:580 SAINT JOHNSBURY RD
Practice Address - Street 2:SUITE K
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-3437
Practice Address - Country:US
Practice Address - Phone:603-444-2010
Practice Address - Fax:603-444-2181
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2009-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0444P208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT9000143Medicaid
NH30332083Medicaid
NHAP1838Medicare ID - Type Unspecified
P73847Medicare UPIN
VT9000143Medicaid