Healthcare Provider Details

I. General information

NPI: 1194038562
Provider Name (Legal Business Name): COURTNEY MICHELE HAWKINS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2010
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 RIVER RD
CLEARFIELD PA
16830-6026
US

IV. Provider business mailing address

1900 RIVER RD
CLEARFIELD PA
16830-6026
US

V. Phone/Fax

Practice location:
  • Phone: 814-765-0221
  • Fax: 814-765-8499
Mailing address:
  • Phone: 814-765-0221
  • Fax: 814-765-8499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberOA007695
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA054408
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: