Provider Demographics
NPI:1780952887
Name:HAWK, NICOLE KATHLEEN (AUD CCC-A)
Entity type:Individual
Prefix:DR
First Name:NICOLE
Middle Name:KATHLEEN
Last Name:HAWK
Suffix:
Gender:F
Credentials:AUD CCC-A
Other - Prefix:DR
Other - First Name:NICOLE
Other - Middle Name:KATHLEEN
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD CCC-A
Mailing Address - Street 1:9430 PARK WEST BLVD
Mailing Address - Street 2:SUITE 335
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4200
Mailing Address - Country:US
Mailing Address - Phone:865-693-6065
Mailing Address - Fax:
Practice Address - Street 1:9430 PARK WEST BLVD
Practice Address - Street 2:SUITE 335
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4200
Practice Address - Country:US
Practice Address - Phone:865-693-6065
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1133231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist