Provider Demographics
NPI:1134786767
Name:HAWKINS, STEVEN W (ATC)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:W
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11019 COTTONWOOD ST
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2079
Mailing Address - Country:US
Mailing Address - Phone:913-481-2769
Mailing Address - Fax:
Practice Address - Street 1:11019 COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-2079
Practice Address - Country:US
Practice Address - Phone:913-481-2769
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-20
Last Update Date:2019-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS24-001322255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer