Provider Demographics
NPI:1285519157
Name:HAWKINS, BRANDY DAUN (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:DAUN
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:BRANDY
Other - Middle Name:DAUN
Other - Last Name:FORTNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2410 JANNA AVE
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1910
Mailing Address - Country:US
Mailing Address - Phone:209-529-9546
Mailing Address - Fax:
Practice Address - Street 1:2243 W RUMBLE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-0219
Practice Address - Country:US
Practice Address - Phone:209-529-9892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-08
Last Update Date:2025-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95131280163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice