Healthcare Provider Details

I. General information

NPI: 1487378816
Provider Name (Legal Business Name): MARQUITA REYNOLDS HAWKINS AGNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2022
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4799 WOODFORD CIR
BESSEMER AL
35022-2002
US

IV. Provider business mailing address

FEDERAL INJURY CENTER 650 9TH AVENUE SW
BESSEMER AL
35022
US

V. Phone/Fax

Practice location:
  • Phone: 205-461-6224
  • Fax:
Mailing address:
  • Phone: 205-461-6224
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1-130085
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: