Individual provider · NPI-1

Maranda Hawkins

Registered Nurse, General Practice · Bloomington, IN

NPI number1629646393
StatusActive
Last updated in NPPESJun 17, 2021

Details

NPI
1629646393
Entity type
Individual (NPI-1)
Name
Maranda Hawkins
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 17, 2021
Certification date
Jun 17, 2021
Last updated
Jun 17, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
163WG0000X Registered Nurse, General Practice28191860AINYes

Practice location

363 S Fieldstone Blvd
Bloomington, IN 47403-9809

Phone 812-825-0551

Mailing address

363 S Fieldstone Blvd
Bloomington, IN 47403-9809

Phone 812-825-0551

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