Provider Demographics
NPI:1437820198
Name:HAWKS, KELLY SHER'EL (PHARMACY TECHNICIAN)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:SHER'EL
Last Name:HAWKS
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4401 GARDENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93309-6378
Mailing Address - Country:US
Mailing Address - Phone:661-472-9155
Mailing Address - Fax:
Practice Address - Street 1:8000 WHITE LN
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7688
Practice Address - Country:US
Practice Address - Phone:661-837-2198
Practice Address - Fax:661-837-1262
Is Sole Proprietor?:No
Enumeration Date:2021-09-22
Last Update Date:2021-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11876183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician