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General NPI Number Information
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NPI Number | 1972984581
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Entity Type | Individual
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Provider Name | JENNIFER LYNN HAWKEN MD
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Gender | Female
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Dates
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Enumeration Date | 06/10/2015
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 111 EDGARTOWN RD
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City | OAK BLUFFS
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State | MA
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Zip | 02557
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Country | US
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Telephone | 508-693-7900
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Fax | 508-696-0401
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Provider Business Mailing Address
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Address Line | 1768 BUSINESS CENTER DR STE 360
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City | RESTON
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State | VA
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Zip | 20190-5358
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Country | US
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Telephone | 703-592-6449
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Fax | 678-487-5346
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | LP03520
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License Number State | RI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 278494
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License Number State | MA
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