Provider Demographics
NPI:1750453890
Name:HAWKINSON, NICOLA VICTORIA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:NICOLA
Middle Name:VICTORIA
Last Name:HAWKINSON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:380 2ND AVE
Mailing Address - Street 2:SUITE 1001
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010
Mailing Address - Country:US
Mailing Address - Phone:212-460-0180
Mailing Address - Fax:646-878-1616
Practice Address - Street 1:303 2ND AVE
Practice Address - Street 2:SUITE 19
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003
Practice Address - Country:US
Practice Address - Phone:212-460-0180
Practice Address - Fax:646-878-1616
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF430137363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2E6781Medicare ID - Type Unspecified
P62580Medicare UPIN