Provider Demographics
NPI:1194038562
Name:HAWKINS, COURTNEY MICHELE (PA-C)
Entity type:Individual
Prefix:MS
First Name:COURTNEY
Middle Name:MICHELE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3285 UTAHVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COALPORT
Mailing Address - State:PA
Mailing Address - Zip Code:16627-9359
Mailing Address - Country:US
Mailing Address - Phone:814-577-5527
Mailing Address - Fax:
Practice Address - Street 1:1951 PINE HALL RD STE 225
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801-5107
Practice Address - Country:US
Practice Address - Phone:814-237-0001
Practice Address - Fax:814-237-0116
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2024-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA054408363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical