Provider Demographics
NPI:1699435941
Name:HAWKINS, KATHLEEN ALICIA
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ALICIA
Last Name:HAWKINS
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 1:1501 TRINIDAD AVE NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002-2813
Mailing Address - Country:US
Mailing Address - Phone:202-321-2640
Mailing Address - Fax:
Practice Address - Street 1:1412 TRINIDAD AVE NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-2812
Practice Address - Country:US
Practice Address - Phone:202-399-6698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-28
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant