Healthcare Provider Details

I. General information

NPI: 1205009230
Provider Name (Legal Business Name): REBECCA ERIN HAWLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/10/2008
Last Update Date: 04/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1351 NEWTOWN PIKE
LEXINGTON KY
40511-1217
US

IV. Provider business mailing address

3163 CUSTER DRIVE
LEXINGTON KY
40517-1217
US

V. Phone/Fax

Practice location:
  • Phone: 859-254-2743
  • Fax:
Mailing address:
  • Phone: 859-271-9448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: