Provider Demographics
NPI:1215376447
Name:HAWKINS, NATASHA ANASTASIA
Entity Type:Individual
Prefix:MRS
First Name:NATASHA
Middle Name:ANASTASIA
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 1:1707 LINWOOD DR STE G
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-5365
Mailing Address - Country:US
Mailing Address - Phone:870-604-4455
Mailing Address - Fax:
Practice Address - Street 1:1707 LINWOOD DR STE G
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-5365
Practice Address - Country:US
Practice Address - Phone:870-604-4455
Practice Address - Fax:888-977-2956
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR197369795Medicaid