Provider Demographics
NPI:1134980246
Name:HAWS, LILY RUTH
Entity type:Individual
Prefix:MRS
First Name:LILY
Middle Name:RUTH
Last Name:HAWS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LILY
Other - Middle Name:RUTH
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:708 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:OH
Mailing Address - Zip Code:43050-1720
Mailing Address - Country:US
Mailing Address - Phone:740-397-5397
Mailing Address - Fax:
Practice Address - Street 1:708 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:OH
Practice Address - Zip Code:43050-1720
Practice Address - Country:US
Practice Address - Phone:740-397-5397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker