Healthcare Provider Details

I. General information

NPI: 1518691096
Provider Name (Legal Business Name): ASHLEY HAWKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2022
Last Update Date: 08/12/2022
Certification Date: 08/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

286 JASPER LN
MEDINA OH
44256-2159
US

V. Phone/Fax

Practice location:
  • Phone: 216-212-3009
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SE0003X
TaxonomyEmergency Clinical Nurse Specialist
License NumberAPRN.CNS.0019468
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number351021
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: