Provider Demographics
NPI:1285870667
Name:LAWLER, KELLY HAWKS (FNP)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:HAWKS
Last Name:LAWLER
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 1:324 LONG SHOALS RD
Mailing Address - Street 2:CVS #7884
Mailing Address - City:ARDEN
Mailing Address - State:NC
Mailing Address - Zip Code:28704-8794
Mailing Address - Country:US
Mailing Address - Phone:828-654-0812
Mailing Address - Fax:
Practice Address - Street 1:324 LONG SHOALS RD
Practice Address - Street 2:CVS #7884
Practice Address - City:ARDEN
Practice Address - State:NC
Practice Address - Zip Code:28704-8794
Practice Address - Country:US
Practice Address - Phone:828-654-0812
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2014-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201457363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
2802323OtherMEDICARE I.D.#