Individual
MS. ETHEL MARIE HAWKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
3713 E ARABELLA ST, LONG BEACH, CA 90805-3915
(562) 786-4994
(562) 630-3588
Mailing address
3713 E ARABELLA ST, LONG BEACH, CA 90805-3915
(562) 786-4994
(562) 630-3588
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN136932
CA
2278S1500X
SNF/Subacute Care Certified Respiratory Therapist
VN136932
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005100
RVN
CA
01
—
08162007778841
TRACKING NUMBER
CA
01
—
164X00000X
TAXONONY
CA
01
—
EPS-016990
PROVDER NUMBER
CA
Enumeration date
08/16/2007
Last updated
11/11/2008
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