Provider Demographics
NPI:1912397589
Name:HAWTHORNE, ALEXANDER (CRNA)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:
Last Name:HAWTHORNE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1206 OLD CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-4848
Mailing Address - Country:US
Mailing Address - Phone:412-952-8998
Mailing Address - Fax:
Practice Address - Street 1:1206 OLD CONCORD RD
Practice Address - Street 2:
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-4848
Practice Address - Country:US
Practice Address - Phone:412-952-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-03
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN610229367500000X
FL106057367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Single Specialty