Provider Demographics
NPI:1043773484
Name:COCKINGHAM-HAWKINS, TINA R
Entity Type:Individual
Prefix:
First Name:TINA
Middle Name:R
Last Name:COCKINGHAM-HAWKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1496 SHERBROOK RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-2762
Mailing Address - Country:US
Mailing Address - Phone:216-269-1182
Mailing Address - Fax:
Practice Address - Street 1:5000 S SEDGEWICK RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-1113
Practice Address - Country:US
Practice Address - Phone:216-313-3828
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-11
Last Update Date:2019-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker