Provider Demographics
NPI:1982329033
Name:HAWKINS, KELLIE (DMIN, MED, BS)
Entity Type:Individual
Prefix:DR
First Name:KELLIE
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:DMIN, MED, BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 SHADYBROOK DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45216-1007
Mailing Address - Country:US
Mailing Address - Phone:513-484-7223
Mailing Address - Fax:
Practice Address - Street 1:147 SHADYBROOK DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45216-1007
Practice Address - Country:US
Practice Address - Phone:513-484-7223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-10
Last Update Date:2022-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No374U00000XNursing Service Related ProvidersHome Health Aide
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral