MEDICARE: REBECCA HAWKINS FNP-C

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	F0916188	IN
2	363LF0000X	Family Nurse Practitioner	71006666AB	IN

General Provider Information

NPI Number	:	1245789924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA HAWKINS FNP-C

Provider Business Mailing Address
First Line	:	1674 CASCADE DRIVE
Second Line	:
City	:	GREENWOOD
State	:	IN
Zip	:	46143-6227
Country	:	US
Telephone Number	:	317-865-0723
Fax Number	:

Provider Business Practice Location Address
First Line	:	2085 ACORN BLVD
Second Line	:
City	:	FRANKLIN
State	:	IN
Zip	:	46131-7306
Country	:	US
Telephone Number	:	317-346-2273
Fax Number	:

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

Provider Enumeration Date	:	09/23/2016
Last Update Date	:	04/05/2017

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