Provider Demographics
NPI:1275624462
Name:HAWKINS, CHRISTINE M (FNP)
Entity Type:Individual
Prefix:
First Name:CHRISTINE
Middle Name:M
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-2520
Mailing Address - Country:US
Mailing Address - Phone:219-413-5100
Mailing Address - Fax:574-465-9502
Practice Address - Street 1:1960 NORTHSIDE BLVD
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46615
Practice Address - Country:US
Practice Address - Phone:574-307-7673
Practice Address - Fax:574-234-4706
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000874A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200267230Medicaid
IN163500GMedicare ID - Type Unspecified