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NPI Code Detail

MEDICARE: MR. KENNETH NEAL HAWKER JR. FNP

MEDICARE: MR. KENNETH NEAL HAWKER JR. FNP
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
1363LF0000XFamily Nurse Practitioner0024179848VA

General Provider Information

NPI Number : 1356958565
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KENNETH NEAL HAWKER JR. FNP
Provider Business Mailing Address
First Line : 136 CAPRI CT
Second Line :
City : DANVILLE
State : VA
Zip : 24541-5116
Country : US
Telephone Number : 434-334-2706
Fax Number :
Provider Business Practice Location Address
First Line : 136 CAPRI CT
Second Line :
City : DANVILLE
State : VA
Zip : 24541-5116
Country : US
Telephone Number : 434-334-2706
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/30/2020
Last Update Date : 09/30/2020

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