Provider Demographics
NPI:1427461888
Name:HAWKINS, MICHA KIM (NP)
Entity type:Individual
Prefix:
First Name:MICHA
Middle Name:KIM
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9300 SW 165TH ST
Mailing Address - Street 2:
Mailing Address - City:PALMETTO BAY
Mailing Address - State:FL
Mailing Address - Zip Code:33157-3449
Mailing Address - Country:US
Mailing Address - Phone:305-979-7781
Mailing Address - Fax:305-553-9753
Practice Address - Street 1:9300 SW 165TH ST
Practice Address - Street 2:
Practice Address - City:PALMETTO BAY
Practice Address - State:FL
Practice Address - Zip Code:33157-3449
Practice Address - Country:US
Practice Address - Phone:305-979-7081
Practice Address - Fax:305-553-9753
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2014-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP2753102363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily