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General NPI Number Information
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NPI Number | 1699262857
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Entity Type | Individual
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Provider Name | PAMELA NOWELL HAWK LPN
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Gender | Female
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Dates
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Enumeration Date | 04/13/2018
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Last Update Date | 04/13/2018
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Provider Practice Location Address
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Address Line | 1596 HIGHWAY 33 S
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City | NEW TAZEWELL
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State | TN
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Zip | 37825-7104
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Country | US
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Telephone | 423-626-8271
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Fax | 865-342-0106
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Provider Business Mailing Address
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Address Line | 1923 SULPHUR SPRINGS RD
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City | MORRISTOWN
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State | TN
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Zip | 37813-5654
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Country | US
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Telephone | 423-317-9344
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Fax | 423-714-2355
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 91687
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License Number State | TN
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