Healthcare Provider Details

I. General information

NPI: 1124930854
Provider Name (Legal Business Name): TERRELL L HAWKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2026
Last Update Date: 09/18/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13813-B/C WARWICK BLVD SUITE 8
NEWPORT NEWS VA
23602
US

IV. Provider business mailing address

13813-B/C WARWICK BLVD SUITE 8
NEWPORT NEWS VA
23602
US

V. Phone/Fax

Practice location:
  • Phone: 757-719-4354
  • Fax:
Mailing address:
  • Phone: 757-719-4354
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number0019011589
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: