Provider Demographics
NPI:1194412577
Name:HAWKINS, JAMIE LYNN (RN)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 CAMINO SABANERO
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87508-4836
Mailing Address - Country:US
Mailing Address - Phone:505-690-1539
Mailing Address - Fax:
Practice Address - Street 1:4851 PASEO DEL SOL
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87507-3027
Practice Address - Country:US
Practice Address - Phone:505-231-8831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-18
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR60276163W00000X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163W00000XNursing Service ProvidersRegistered Nurse