Healthcare Provider Details

I. General information

NPI: 1902729395
Provider Name (Legal Business Name): SYDNEY HAWKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1408 WALKER AVE
GREENSBORO NC
27412-5020
US

IV. Provider business mailing address

505 WOODLAND DR
MADISON NC
27025-2246
US

V. Phone/Fax

Practice location:
  • Phone: 336-334-5000
  • Fax:
Mailing address:
  • Phone: 336-394-5654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: