Provider Demographics
NPI:1629417399
Name:HAWKINS, TERRI
Entity Type:Individual
Prefix:
First Name:TERRI
Middle Name:
Last Name:HAWKINS
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 1:3510 W CENTRAL AVE
Mailing Address - Street 2:SUITE #400
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67203-4951
Mailing Address - Country:US
Mailing Address - Phone:316-519-1627
Mailing Address - Fax:316-945-4723
Practice Address - Street 1:3510 W CENTRAL AVE
Practice Address - Street 2:SUITE #400
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67203-4951
Practice Address - Country:US
Practice Address - Phone:316-519-1627
Practice Address - Fax:316-945-4723
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies