Healthcare Provider Details

I. General information

NPI: 1639342264
Provider Name (Legal Business Name): ANI (ANN) KATHERINE HAWKINSON N.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2008
Last Update Date: 04/03/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36A OLD TOWN RD
PUTNEY VT
05346-8533
US

IV. Provider business mailing address

36A OLD TOWN RD
PUTNEY VT
05346-8533
US

V. Phone/Fax

Practice location:
  • Phone: 802-387-2345
  • Fax:
Mailing address:
  • Phone: 802-387-2345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number099-0000235
License Number StateVT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: