Provider Demographics
NPI:1154633865
Name:HAWKINS, CHERRY (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHERRY
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 E CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGBORO
Mailing Address - State:OH
Mailing Address - Zip Code:45066-8553
Mailing Address - Country:US
Mailing Address - Phone:937-207-0975
Mailing Address - Fax:
Practice Address - Street 1:325 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SPRINGBORO
Practice Address - State:OH
Practice Address - Zip Code:45066-8553
Practice Address - Country:US
Practice Address - Phone:937-207-0975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-10
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.13998-NP363LF0000X
FLAPRN11002363363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3020680Medicaid
FLRN9508631OtherRN FL
FLAPRN11002363OtherAPRN FL