MEDICARE: RACHEL ROSE KIMBLE HAWKINS MSW

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	1041C0700X	Clinical Social Worker	22624	MN

General Provider Information

NPI Number	:	1578077723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL ROSE KIMBLE HAWKINS MSW

Provider Business Mailing Address
First Line	:	3420 24TH AVE S
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55406-2502
Country	:	US
Telephone Number	:	952-484-4243
Fax Number	:

Provider Business Practice Location Address
First Line	:	4 E 43RD ST STE 202
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55409-2018
Country	:	US
Telephone Number	:	952-484-4243
Fax Number	:

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

Provider Enumeration Date	:	11/27/2017
Last Update Date	:	04/13/2026

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