Provider Demographics
NPI:1922691138
Name:HAWK, PATRICIA (RN CM)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:HAWK
Suffix:
Gender:F
Credentials:RN CM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 LUMBERJACK RD
Mailing Address - Street 2:
Mailing Address - City:SCHERR
Mailing Address - State:WV
Mailing Address - Zip Code:26726-8874
Mailing Address - Country:US
Mailing Address - Phone:304-257-6224
Mailing Address - Fax:304-749-7053
Practice Address - Street 1:411 LUMBERJACK RD
Practice Address - Street 2:
Practice Address - City:SCHERR
Practice Address - State:WV
Practice Address - Zip Code:26726-8874
Practice Address - Country:US
Practice Address - Phone:304-257-6224
Practice Address - Fax:304-749-7053
Is Sole Proprietor?:No
Enumeration Date:2021-02-18
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV43305163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0600XNursing Service ProvidersRegistered NurseGerontology