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NPI Code Detail

MEDICARE: TRACY LYNN HAWSE PA LLC

MEDICARE: TRACY LYNN HAWSE PA LLC
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
1363LF0000XFamily Nurse Practitioner101-0138767VT
2363LA2200XAdult Health Nurse Practitioner111807-23NH
3363LA2200XAdult Health Nurse Practitioner95013954CA
4363LA2200XAdult Health Nurse Practitioner11004875FL

General Provider Information

NPI Number : 1760026504
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRACY LYNN HAWSE PA LLC
Provider Business Mailing Address
First Line : 20 BOW ST
Second Line :
City : CONCORD
State : NH
Zip : 03301-2701
Country : US
Telephone Number : 603-270-9217
Fax Number : 603-232-1376
Provider Business Practice Location Address
First Line : 66 PROSPECT ST
Second Line :
City : MANCHESTER
State : NH
Zip : 03104-3506
Country : US
Telephone Number : 603-270-9217
Fax Number : 603-232-1376
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/05/2019
Last Update Date : 02/03/2026

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