Provider Demographics
NPI:1205912557
Name:HAWKINS, ANDREA S (PA)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:S
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6290 MANCHESTER HWY
Mailing Address - Street 2:
Mailing Address - City:MORRISON
Mailing Address - State:TN
Mailing Address - Zip Code:37357-7589
Mailing Address - Country:US
Mailing Address - Phone:931-815-1616
Mailing Address - Fax:931-815-1616
Practice Address - Street 1:6290 MANCHESTER HWY
Practice Address - Street 2:
Practice Address - City:MORRISON
Practice Address - State:TN
Practice Address - Zip Code:37357-7589
Practice Address - Country:US
Practice Address - Phone:931-815-1616
Practice Address - Fax:931-815-1717
Is Sole Proprietor?:No
Enumeration Date:2006-10-30
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1157363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN4111591Medicaid
TNQ25381Medicare UPIN
TN3662589Medicare ID - Type Unspecified