Provider Demographics
NPI:1306599980
Name:HAWES-BERRY, MAEGEN
Entity type:Individual
Prefix:
First Name:MAEGEN
Middle Name:
Last Name:HAWES-BERRY
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 1:1307 CARR ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-4005
Mailing Address - Country:US
Mailing Address - Phone:989-721-6158
Mailing Address - Fax:
Practice Address - Street 1:217 S WATER ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2919
Practice Address - Country:US
Practice Address - Phone:989-494-0553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-02
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant