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General NPI Number Information
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NPI Number | 1083159479
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Entity Type | Individual
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Provider Name | HEATHER JULINE HAWK NP
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Gender | Female
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Dates
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Enumeration Date | 12/21/2016
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Last Update Date | 09/17/2019
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Provider Practice Location Address
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Address Line | PEACEHEALTH MEDICAL GROUP 4545 CORDATA PARKWAY, SUITE 1B
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City | BELLINGHAM
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State | WA
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Zip | 98226
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Country | US
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Telephone | 360-752-5216
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Fax | 360-752-5669
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Provider Business Mailing Address
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Address Line | 670 9TH ST SUITE 203
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City | ARCATA
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State | CA
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Zip | 95521-6248
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Country | US
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Telephone | 707-826-8633
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Fax | 707-826-8628
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 95005626
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | AP60930255
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | AP60930255
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License Number State | WA
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