MEDICARE: VANESSA HAMILTON HAWKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	26NJ01128800	NJ

General Provider Information

NPI Number	:	1003492190
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA HAMILTON HAWKINS

Provider Business Mailing Address
First Line	:	1 N WHITE HORSE PIKE
Second Line	:
City	:	HAMMONTON
State	:	NJ
Zip	:	08037-1875
Country	:	US
Telephone Number	:	609-567-0200
Fax Number	:

Provider Business Practice Location Address
First Line	:	651 HIGH ST
Second Line	:
City	:	BURLINGTON CITY
State	:	NJ
Zip	:	08016-2737
Country	:	US
Telephone Number	:	609-386-0775
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2021
Last Update Date	:	04/07/2021

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