Provider Demographics
NPI:1033653183
Name:HAWTHORNE, SHERRI DENISE (LPN)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:DENISE
Last Name:HAWTHORNE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1274 NW 55TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33142-3132
Mailing Address - Country:US
Mailing Address - Phone:561-325-1948
Mailing Address - Fax:
Practice Address - Street 1:1274 NW 55TH TER
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33142-3132
Practice Address - Country:US
Practice Address - Phone:561-325-1948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPN5226205164W00000X
AL2-063418164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse