Provider Demographics
NPI:1871778480
Name:HAWTHORNE, TINA MARIE (CNP)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:MARIE
Last Name:HAWTHORNE
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1700 BOETTLER RD
Mailing Address - Street 2:STE. 100
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-7792
Mailing Address - Country:US
Mailing Address - Phone:330-896-0009
Mailing Address - Fax:330-896-0032
Practice Address - Street 1:1700 BOETTLER RD
Practice Address - Street 2:STE. 100
Practice Address - City:UNIONTOWN
Practice Address - State:OH
Practice Address - Zip Code:44685-7792
Practice Address - Country:US
Practice Address - Phone:330-896-0009
Practice Address - Fax:330-896-0032
Is Sole Proprietor?:No
Enumeration Date:2008-01-02
Last Update Date:2008-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OHNP-09777363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily