Provider Demographics
NPI:1720963549
Name:HAWKINS, SHELBY (MS, RD, LD)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22127 AL HIGHWAY 117
Mailing Address - Street 2:
Mailing Address - City:IDER
Mailing Address - State:AL
Mailing Address - Zip Code:35981-4211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 16TH ST S UNIT 6028
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1620
Practice Address - Country:US
Practice Address - Phone:256-605-3310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-11
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL86404210133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered