Provider Demographics
NPI:1831411297
Name:HAWK, SONDRA GAYNELLE (LPN)
Entity type:Individual
Prefix:MS
First Name:SONDRA
Middle Name:GAYNELLE
Last Name:HAWK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4901 NE BARRY RD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64156-1219
Mailing Address - Country:US
Mailing Address - Phone:816-437-3656
Mailing Address - Fax:816-437-3660
Practice Address - Street 1:4901 NE BARRY RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64156-1219
Practice Address - Country:US
Practice Address - Phone:816-437-3656
Practice Address - Fax:816-437-3660
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO043186164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse