Provider Demographics
NPI:1689887606
Name:HAWK, JINA J (CFNP)
Entity Type:Individual
Prefix:
First Name:JINA
Middle Name:J
Last Name:HAWK
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 GALE LN
Mailing Address - Street 2:SILOAM FAMILY HEALTH CENTER
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37204-3012
Mailing Address - Country:US
Mailing Address - Phone:615-298-5406
Mailing Address - Fax:615-577-4010
Practice Address - Street 1:820 GALE LN
Practice Address - Street 2:SILOAM FAMILY HEALTH CENTER
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37204-3012
Practice Address - Country:US
Practice Address - Phone:615-298-5406
Practice Address - Fax:615-577-4010
Is Sole Proprietor?:No
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000008424363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ27381Medicare UPIN