Provider Demographics
NPI:1073364485
Name:HAWK, SHARON KAY
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:KAY
Last Name:HAWK
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 1:472 TIMOTHY LN
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905-2231
Mailing Address - Country:US
Mailing Address - Phone:567-303-2220
Mailing Address - Fax:
Practice Address - Street 1:1064 BROOKDALE DR
Practice Address - Street 2:
Practice Address - City:CRESTLINE
Practice Address - State:OH
Practice Address - Zip Code:44827-9678
Practice Address - Country:US
Practice Address - Phone:419-405-4040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider