Provider Demographics
NPI:1710606769
Name:EASTMAN HAWKINS, ANALISE MARIE (MS, FNP)
Entity Type:Individual
Prefix:MRS
First Name:ANALISE
Middle Name:MARIE
Last Name:EASTMAN HAWKINS
Suffix:
Gender:F
Credentials:MS, FNP
Other - Prefix:MISS
Other - First Name:ANALISE
Other - Middle Name:MARIE
Other - Last Name:EASTMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21605 JUSTCO LN
Mailing Address - Street 2:
Mailing Address - City:CASTRO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:94552-4860
Mailing Address - Country:US
Mailing Address - Phone:925-519-4523
Mailing Address - Fax:
Practice Address - Street 1:21605 JUSTCO LN
Practice Address - Street 2:
Practice Address - City:CASTRO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:94552-4860
Practice Address - Country:US
Practice Address - Phone:925-519-4523
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95021537363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner