Provider Demographics
NPI:1598329401
Name:HAWKINS, CHERRELLE (RN, CHES(R), CPHT)
Entity Type:Individual
Prefix:MRS
First Name:CHERRELLE
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:RN, CHES(R), CPHT
Other - Prefix:MRS
Other - First Name:CJ
Other - Middle Name:
Other - Last Name:HAWKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, CHES(R), CPHT
Mailing Address - Street 1:612 RODNEY BAY XING
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-2970
Mailing Address - Country:US
Mailing Address - Phone:703-966-6334
Mailing Address - Fax:
Practice Address - Street 1:1025 W H SMITH BLVD STE 106
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27834-5278
Practice Address - Country:US
Practice Address - Phone:252-830-9001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-25
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
32014174H00000X
183700000X
NC340007163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174H00000XOther Service ProvidersHealth Educator
No183700000XPharmacy Service ProvidersPharmacy Technician