Provider Demographics
NPI:1194407890
Name:HAWKINS, CASSANDRA JO
Entity type:Individual
Prefix:
First Name:CASSANDRA
Middle Name:JO
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1027 LOUS WAY
Mailing Address - Street 2:
Mailing Address - City:SLINGER
Mailing Address - State:WI
Mailing Address - Zip Code:53086-9334
Mailing Address - Country:US
Mailing Address - Phone:321-370-4110
Mailing Address - Fax:
Practice Address - Street 1:1027 LOUS WAY
Practice Address - Street 2:
Practice Address - City:SLINGER
Practice Address - State:WI
Practice Address - Zip Code:53086-9334
Practice Address - Country:US
Practice Address - Phone:321-370-4110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula