Provider Demographics
NPI:1750698155
Name:HAWKINS, KATHERINE (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 RANCHO DE ANIMAS DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87402-3092
Mailing Address - Country:US
Mailing Address - Phone:505-947-8497
Mailing Address - Fax:
Practice Address - Street 1:3540 E MAIN ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87402-5329
Practice Address - Country:US
Practice Address - Phone:505-564-3086
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-07
Last Update Date:2010-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00006807183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist