Healthcare Provider Details

I. General information

NPI: 1760761522
Provider Name (Legal Business Name): BRANDI KAY HAWKINS LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2011
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1307 HIGHWAY 31 NW STE D
HARTSELLE AL
35640-4422
US

IV. Provider business mailing address

1307 HIGHWAY 31 NW STE D
HARTSELLE AL
35640-4422
US

V. Phone/Fax

Practice location:
  • Phone: 256-387-4004
  • Fax: 949-909-8955
Mailing address:
  • Phone: 256-387-4004
  • Fax: 949-909-8955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number2061821
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: