Provider Demographics
NPI:1568805919
Name:HAWKINS, JOSHUA BENTON (CRNA)
Entity Type:Individual
Prefix:MR
First Name:JOSHUA
Middle Name:BENTON
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607A HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-2032
Mailing Address - Country:US
Mailing Address - Phone:304-960-1954
Mailing Address - Fax:
Practice Address - Street 1:3812 N ELM ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27455-2596
Practice Address - Country:US
Practice Address - Phone:336-294-1833
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2020-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV70797367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered