Provider Demographics
NPI:1215579263
Name:HAWE, HALLIE
Entity type:Individual
Prefix:
First Name:HALLIE
Middle Name:
Last Name:HAWE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2084 N CHESTNUT AVE APT 13
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-2242
Mailing Address - Country:US
Mailing Address - Phone:406-533-8446
Mailing Address - Fax:
Practice Address - Street 1:2084 N CHESTNUT AVE APT 13
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-2242
Practice Address - Country:US
Practice Address - Phone:406-533-8446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program