Healthcare Provider Details

I. General information

NPI: 1851260905
Provider Name (Legal Business Name): MRS. ADRIANA HAWKINS-SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/05/2025
Last Update Date: 11/05/2025
Certification Date: 11/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

402 LAKESHORE DR
MCCOMB MS
39648-2269
US

IV. Provider business mailing address

402 LAKESHORE DR
MCCOMB MS
39648-2269
US

V. Phone/Fax

Practice location:
  • Phone: 601-249-6686
  • Fax:
Mailing address:
  • Phone: 601-249-6686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number StateMS
# 3
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: