Provider Demographics
NPI:1831648088
Name:HAWKINS, KRISTOPHER
Entity Type:Individual
Prefix:
First Name:KRISTOPHER
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1501 SAN PEDRO DR SE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87108-5153
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:UNIT 2060, APO AP
Practice Address - Street 2:
Practice Address - City:OSAN AB
Practice Address - State:SOUTH KOREA
Practice Address - Zip Code:96278
Practice Address - Country:KR
Practice Address - Phone:719-964-5906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-29
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical