Provider Demographics
NPI:1649827411
Name:HAWKINS, TANIA
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5744 BAUM BLOUVARD
Mailing Address - Street 2:
Mailing Address - City:SHADYSIDE
Mailing Address - State:PA
Mailing Address - Zip Code:15206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5744 BAUM BLOUVARD
Practice Address - Street 2:
Practice Address - City:SHADYSIDE
Practice Address - State:PA
Practice Address - Zip Code:15206
Practice Address - Country:US
Practice Address - Phone:412-208-5992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-26
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management