Individual
KIRSTEN HAWBAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-6851
Mailing address
282 GRANDVIEW CT, KINGSPORT, TN 37664-5064
(423) 956-9349
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
NONE AVAILABLE
TN
Enumeration date
01/13/2021
Last updated
01/13/2021
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