MEDICARE: KAREN LYNN HAWKINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	376K00000X	Nurse's Aide	401597261213	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	006996001-01	OTHER	OH	UNITED HEALTHCARE
3	CS1817000143	OTHER	OH	CARESOURCE

General Provider Information

NPI Number	:	1083179907
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN LYNN HAWKINS

Provider Business Mailing Address
First Line	:	6316 MAPLEWOOD RD APT I104
Second Line	:
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-1846
Country	:	US
Telephone Number	:	440-305-2975
Fax Number	:

Provider Business Practice Location Address
First Line	:	6316 MAPLEWOOD RD APT I104
Second Line	:
City	:	MAYFIELD HTS
State	:	OH
Zip	:	44124-1846
Country	:	US
Telephone Number	:	440-305-2975
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/05/2019
Last Update Date	:	02/05/2019

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Directions to “ KAREN LYNN HAWKINS ” Practice Location

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