=====================================================
General NPI Number Information
=====================================================
NPI Number | 1659785152
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JESSICA LEE HAWKINS PHARMD
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2014
-----------------------------------------------------
Last Update Date | 08/15/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1101 VETERANS DR
-----------------------------------------------------
City | LEXINGTON
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 40502-2235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 859-233-4511
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 542 LEESBURG FARMS LN
-----------------------------------------------------
City | CYNTHIANA
-----------------------------------------------------
State | KY
-----------------------------------------------------
Zip | 41031-8617
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-621-1020
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 03232903
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | 016674
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 1835C0207X
-----------------------------------------------------
Taxonomy Name | Compounded Sterile Preparations Pharmacist
-----------------------------------------------------
License Number | 016674
-----------------------------------------------------
License Number State | KY
-----------------------------------------------------