Healthcare Provider Details

I. General information

NPI: 1659837318
Provider Name (Legal Business Name): CHERYL HAWKINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/18/2019
Last Update Date: 02/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 CONSTITUTION BLVD
SALINAS CA
93906-3100
US

IV. Provider business mailing address

PO BOX 22544
CARMEL CA
93922-0544
US

V. Phone/Fax

Practice location:
  • Phone: 831-796-1652
  • Fax:
Mailing address:
  • Phone: 831-624-9124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number683625
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: