MEDICARE: MRS. EBONEE HAWKINS NP

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	163W00000X	Registered Nurse	28244759A	IN
2	164W00000X	Licensed Practical Nurse	PN143912 M-IV	OH

General Provider Information

NPI Number	:	1073802070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. EBONEE HAWKINS NP

Provider Business Mailing Address
First Line	:	11837 WEATHERED EDGE DR
Second Line	:
City	:	FISHERS
State	:	IN
Zip	:	46037-3905
Country	:	US
Telephone Number	:	419-322-1622
Fax Number	:	844-918-2455

Provider Business Practice Location Address
First Line	:	2418 ROCKSPRING RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43614-1672
Country	:	US
Telephone Number	:	419-322-1622
Fax Number	:

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

Provider Enumeration Date	:	03/31/2011
Last Update Date	:	02/23/2026

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