Provider Demographics
NPI:1447960877
Name:HAWKINS, ELIZA GRACE (RN)
Entity type:Individual
Prefix:MISS
First Name:ELIZA
Middle Name:GRACE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:RN
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Mailing Address - Street 1:979 CROSS BRONX EXPY
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10460-4885
Mailing Address - Country:US
Mailing Address - Phone:615-788-1106
Mailing Address - Fax:
Practice Address - Street 1:979 CROSS BRONX EXPY
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10460-4885
Practice Address - Country:US
Practice Address - Phone:718-665-7565
Practice Address - Fax:718-665-7595
Is Sole Proprietor?:No
Enumeration Date:2022-11-28
Last Update Date:2024-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN266154163W00000X
TN35073363LP0808X
NY405373363LP0808X
NY899110163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse