Provider Demographics
NPI:1881107928
Name:HAWKEY, LISA MARIE
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:MARIE
Last Name:HAWKEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:139 S COLONIAL AVE # 2
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23221-3517
Mailing Address - Country:US
Mailing Address - Phone:480-322-0282
Mailing Address - Fax:
Practice Address - Street 1:11420 W HUGUENOT RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-1119
Practice Address - Country:US
Practice Address - Phone:480-322-0282
Practice Address - Fax:480-322-0282
Is Sole Proprietor?:No
Enumeration Date:2017-11-12
Last Update Date:2017-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202211002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist