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General NPI Number Information
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NPI Number | 1528168465
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Entity Type | Individual
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Provider Name | MARY E. HAWTHORNE CRNP
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Gender | Female
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 7180 HIGHLAND DRIVE BEHAVIORAL HEALTH SERVICE LINE (116A)
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City | PITTSBURGH
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State | PA
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Zip | 15206
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Country | US
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Telephone | 412-365-4427
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Fax |
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Provider Business Mailing Address
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Address Line | 114 BLUE RIDGE DRIVE
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City | CRANBERRY TOWNSHIP
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State | PA
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Zip | 16066
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Country | US
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Telephone | 724-772-0978
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | TP 001765C
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License Number State | PA
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