Healthcare Provider Details

I. General information

NPI: 1710527544
Provider Name (Legal Business Name): DOMINIQUE J HAWKINS NURSE PRACTITIONER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/09/2020
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 BATTLEFIELD BLVD N STE 100
CHESAPEAKE VA
23320-0305
US

IV. Provider business mailing address

4501 N WITCHDUCK RD STE E
VIRGINIA BEACH VA
23455-6217
US

V. Phone/Fax

Practice location:
  • Phone: 800-244-0680
  • Fax:
Mailing address:
  • Phone: 757-821-7477
  • Fax: 757-383-9660

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024178672
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: