Provider Demographics
NPI:1295623957
Name:HAWKINS, DESIREE NICOLE (CRNP)
Entity type:Individual
Prefix:
First Name:DESIREE
Middle Name:NICOLE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2770 CARDINAL DR
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-8048
Mailing Address - Country:US
Mailing Address - Phone:814-566-1610
Mailing Address - Fax:
Practice Address - Street 1:5165 IMPERIAL PKWY
Practice Address - Street 2:
Practice Address - City:GIRARD
Practice Address - State:PA
Practice Address - Zip Code:16417-9524
Practice Address - Country:US
Practice Address - Phone:814-774-3128
Practice Address - Fax:814-774-0915
Is Sole Proprietor?:No
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP033168207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine