Provider Demographics
NPI:1528168465
Name:HAWTHORNE, MARY E (CRNP)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:E
Last Name:HAWTHORNE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:114 BLUE RIDGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066
Mailing Address - Country:US
Mailing Address - Phone:724-772-0978
Mailing Address - Fax:
Practice Address - Street 1:7180 HIGHLAND DRIVE
Practice Address - Street 2:BEHAVIORAL HEALTH SERVICE LINE (116A)
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206
Practice Address - Country:US
Practice Address - Phone:412-365-4427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP 001765C363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health