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General NPI Number Information
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NPI Number | 1801131800
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Entity Type | Individual
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Provider Name | KATHERINE HAWKINS ANDREWS PA-C
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Gender | Female
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Dates
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Enumeration Date | 12/01/2012
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Last Update Date | 01/30/2025
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Provider Practice Location Address
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Address Line | 3101 E STATE ST STE 21020
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City | EAGLE
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State | ID
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Zip | 83616-6232
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Country | US
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Telephone | 208-473-3275
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Fax | 208-473-3276
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Provider Business Mailing Address
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Address Line | 190 E BANNOCK ST
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City | BOISE
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State | ID
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Zip | 83712-6241
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Country | US
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Telephone |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA1028
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License Number State | ID
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