MEDICARE: LAURA HAWKINS LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	175F00000X	Naturopath	4384	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4384	OTHER	NM	LMT LICENSE

General Provider Information

NPI Number	:	1194733899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAURA HAWKINS LMT

Provider Business Mailing Address
First Line	:	PO BOX 744
Second Line	:
City	:	FAIRACRES
State	:	NM
Zip	:	88033-0744
Country	:	US
Telephone Number	:	505-571-8300
Fax Number	:

Provider Business Practice Location Address
First Line	:	471 WAGON WHEEL TRL
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-8713
Country	:	US
Telephone Number	:	505-571-8300
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/04/2006
Last Update Date	:	07/08/2007

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Directions to “ LAURA HAWKINS LMT” Practice Location

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