Provider Demographics
NPI:1720586001
Name:HAWKINS, JACINTE (FNP)
Entity Type:Individual
Prefix:
First Name:JACINTE
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2108 SPRING LAKE WAY
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-3091
Mailing Address - Country:US
Mailing Address - Phone:843-513-2620
Mailing Address - Fax:
Practice Address - Street 1:920 TRAVELERS BLVD
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8213
Practice Address - Country:US
Practice Address - Phone:843-875-9053
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-01
Last Update Date:2018-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCF12170147363LF0000X
SC21507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily