Provider Demographics
NPI:1669261517
Name:HAWKINS, JASMINE R
Entity type:Individual
Prefix:
First Name:JASMINE
Middle Name:R
Last Name:HAWKINS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:823 S CHURCH ST APT 4305
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-4744
Mailing Address - Country:US
Mailing Address - Phone:417-540-7579
Mailing Address - Fax:
Practice Address - Street 1:607 GROVE RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4208
Practice Address - Country:US
Practice Address - Phone:864-766-2001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program