Provider Demographics
NPI:1235445800
Name:HAWLEY, JENNIFER LYNN
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LYNN
Last Name:HAWLEY
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:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:SENECA CASTLE
Mailing Address - State:NY
Mailing Address - Zip Code:14547-0211
Mailing Address - Country:US
Mailing Address - Phone:067-368-7202
Mailing Address - Fax:
Practice Address - Street 1:2082 BUFFALO STREET
Practice Address - Street 2:
Practice Address - City:SENECA CASLET
Practice Address - State:NY
Practice Address - Zip Code:14547
Practice Address - Country:US
Practice Address - Phone:607-368-7202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker