MEDICARE: MR. JOSHUA BENTON HAWKINS CRNA

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	367500000X	Certified Registered Nurse Anesthetist	0024178764	VA
2	367500000X	Certified Registered Nurse Anesthetist	70797	WV
3	367500000X	Certified Registered Nurse Anesthetist	1327	NC

General Provider Information

NPI Number	:	1568805919
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSHUA BENTON HAWKINS CRNA

Provider Business Mailing Address
First Line	:	5 NOTTING HILL CT
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27410-9751
Country	:	US
Telephone Number	:	304-960-1954
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 MEDICAL CENTER BLVD
Second Line	:
City	:	WINSTON SALEM
State	:	NC
Zip	:	27157-0001
Country	:	US
Telephone Number	:	336-716-2011
Fax Number	:

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

Provider Enumeration Date	:	04/15/2013
Last Update Date	:	03/02/2026

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