Provider Demographics
NPI:1851823769
Name:HAWKEN, JESSICA BROOKE (MD)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:BROOKE
Last Name:HAWKEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3600 FORBES AVENUE
Mailing Address - Street 2:FORBES TOWER-PLAZA LEVEL SUITE 140
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213
Mailing Address - Country:US
Mailing Address - Phone:410-554-2857
Mailing Address - Fax:410-554-4326
Practice Address - Street 1:300 STATE STREET HAND MICRO SURGERY & RECONSTRUCTIVE
Practice Address - Street 2:DEPT OF ORTHOPAEDIC SURGERY
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16507
Practice Address - Country:US
Practice Address - Phone:814-456-6022
Practice Address - Fax:410-554-4326
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2023-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MDD96887207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program