Provider Demographics
NPI:1083475321
Name:HAWES, KARYN LAVON (RN)
Entity Type:Individual
Prefix:MS
First Name:KARYN
Middle Name:LAVON
Last Name:HAWES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:KARYN
Other - Middle Name:LAVON
Other - Last Name:HAWES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2659 CONGRESS WAY
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-8509
Mailing Address - Country:US
Mailing Address - Phone:484-983-5608
Mailing Address - Fax:
Practice Address - Street 1:670 W FIREWEED LN STE 160
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-2561
Practice Address - Country:US
Practice Address - Phone:907-770-0862
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-23
Last Update Date:2024-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA288328163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse