Provider Demographics
NPI:1659536613
Name:HAWK, SARA LYNN (CRNA)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:LYNN
Last Name:HAWK
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16392 R45 HWY
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:IA
Mailing Address - Zip Code:50240-9059
Mailing Address - Country:US
Mailing Address - Phone:515-240-3248
Mailing Address - Fax:
Practice Address - Street 1:700 E UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:DES
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:515-263-5628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-18
Last Update Date:2010-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD-102272367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered