Basic Information
Provider Information
NPI: 1518082627
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAWKS
FirstName: AMANDA
MiddleName: KAY
NamePrefix:  
NameSuffix:  
Credential: PA C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 200 LOTHROP ST
Address2: FORBES TOWER ROOM 9055
City: PITTSBURGH
State: PA
PostalCode: 152132536
CountryCode: US
TelephoneNumber: 4126473087
FaxNumber: 4126474486
Practice Location
Address1: 1310 LIBERTY ST
Address2:  
City: FRANKLIN
State: PA
PostalCode: 16323
CountryCode: US
TelephoneNumber: 8144323163
FaxNumber: 8144372417
Other Information
ProviderEnumerationDate: 03/20/2007
LastUpdateDate: 04/27/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000XMA051977PAY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


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