MEDICARE: MRS. ANDREA S HAWKINS PA

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	363AM0700X	Medical Physician Assistant	1157	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205912557
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ANDREA S HAWKINS PA

Provider Business Mailing Address
First Line	:	6290 MANCHESTER HWY
Second Line	:
City	:	MORRISON
State	:	TN
Zip	:	37357-7589
Country	:	US
Telephone Number	:	931-815-1616
Fax Number	:	931-815-1616

Provider Business Practice Location Address
First Line	:	6290 MANCHESTER HWY
Second Line	:
City	:	MORRISON
State	:	TN
Zip	:	37357-7589
Country	:	US
Telephone Number	:	931-815-1616
Fax Number	:	931-815-1717

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

Provider Enumeration Date	:	10/30/2006
Last Update Date	:	03/21/2019

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