Provider Demographics
NPI:1295350361
Name:HAWKINS, AMBER ROSE (MSN, APRN, CPNP-PC)
Entity type:Individual
Prefix:
First Name:AMBER ROSE
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:X
Credentials:MSN, APRN, CPNP-PC
Other - Prefix:
Other - First Name:AMBER ROSE
Other - Middle Name:
Other - Last Name:KING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN, APRN, CPNP-PC
Mailing Address - Street 1:1760 HONOAPIILANI HWY UNIT 10007
Mailing Address - Street 2:
Mailing Address - City:LAHAINA
Mailing Address - State:HI
Mailing Address - Zip Code:96761-5001
Mailing Address - Country:US
Mailing Address - Phone:901-428-4819
Mailing Address - Fax:
Practice Address - Street 1:1760 HONOAPIILANI HWY UNIT 10007
Practice Address - Street 2:
Practice Address - City:LAHAINA
Practice Address - State:HI
Practice Address - Zip Code:96761-5001
Practice Address - Country:US
Practice Address - Phone:901-428-4819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-14
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN27248363LP0200X
NM61153363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty