Basic Information
| Provider Information | |||||||||
| NPI: | 1780234369 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAWKES | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | CHRISTOPHER | ||||||||
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| Credential: | NP-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1230 S SUNNYVALE | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852066700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4802783275 | ||||||||
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| Practice Location | |||||||||
| Address1: | 7233 E BASELINE RD STE 126 | ||||||||
| Address2: | |||||||||
| City: | MESA | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 852095007 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4806992222 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2019 | ||||||||
| LastUpdateDate: | 09/16/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | RNP232235 | AZ | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.