Provider Demographics
NPI:1770185365
Name:HAWKINS, MARLENE FRANCES (RPH)
Entity Type:Individual
Prefix:
First Name:MARLENE
Middle Name:FRANCES
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:174 CYPRESS POINT PKWY
Mailing Address - Street 2:
Mailing Address - City:PALM COAST
Mailing Address - State:FL
Mailing Address - Zip Code:32164-7438
Mailing Address - Country:US
Mailing Address - Phone:386-445-7548
Mailing Address - Fax:386-445-5932
Practice Address - Street 1:174 CYPRESS POINT PKWY
Practice Address - Street 2:
Practice Address - City:PALM COAST
Practice Address - State:FL
Practice Address - Zip Code:32164-7438
Practice Address - Country:US
Practice Address - Phone:386-445-7548
Practice Address - Fax:386-445-5932
Is Sole Proprietor?:No
Enumeration Date:2020-11-10
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS33365183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist