Individual
KENNETH WAYNE HAWKINS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, FNP
Contact information
Practice address
4364 HIGHWAY 51 S, SENATOBIA, MS 38668-2534
(662) 560-5966
(662) 560-5969
Mailing address
1642 TARA DR, HERNANDO, MS 38632-1633
(662) 501-6068
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902293
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00772751
—
MS
Enumeration date
11/10/2017
Last updated
03/07/2023
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