Provider Demographics
NPI:1154612307
Name:HAWKINS, JACQUELINE LEIGH (FNP)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:LEIGH
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9411 N OAK TRFY STE LL1
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-2262
Mailing Address - Country:US
Mailing Address - Phone:816-691-1655
Mailing Address - Fax:
Practice Address - Street 1:5330 NW 64TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64151-2414
Practice Address - Country:US
Practice Address - Phone:816-691-3065
Practice Address - Fax:816-346-7115
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS5375379091363LF0000X
MO2011010122363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily