Provider Demographics
NPI:1932332921
Name:HAWKINS, JUSTINE MARIE (RPH)
Entity Type:Individual
Prefix:
First Name:JUSTINE
Middle Name:MARIE
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 1:11721 PACESFERRY DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27614-9077
Mailing Address - Country:US
Mailing Address - Phone:919-846-4736
Mailing Address - Fax:919-846-4736
Practice Address - Street 1:11721 PACESFERRY DR
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27614-9077
Practice Address - Country:US
Practice Address - Phone:919-846-4736
Practice Address - Fax:919-846-4736
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-25
Last Update Date:2009-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036444183500000X
NC13648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist