Provider Demographics
NPI:1730189036
Name:HAWKER, ANNA (FNP)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:HAWKER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1880 FILLMORE STREET
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-5029
Mailing Address - Country:US
Mailing Address - Phone:208-735-8386
Mailing Address - Fax:208-735-0434
Practice Address - Street 1:1880 FILLMORE STREET
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3015
Practice Address - Country:US
Practice Address - Phone:208-735-8386
Practice Address - Fax:208-735-0434
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDNP710A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID807196200Medicaid
IDQ49019Medicare UPIN
ID1345098Medicare PIN
ID807196200Medicaid