Provider Demographics
NPI:1306384086
Name:HAWKINS, SHENAKWA (APRN, RN)
Entity Type:Individual
Prefix:MRS
First Name:SHENAKWA
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:APRN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 N RANCHO DR STE 103
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89130-3361
Mailing Address - Country:US
Mailing Address - Phone:725-780-7880
Mailing Address - Fax:725-780-7890
Practice Address - Street 1:2580 N RANCHO DR STE 103
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-3361
Practice Address - Country:US
Practice Address - Phone:725-780-7880
Practice Address - Fax:725-780-7890
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPRN002399363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100551032Medicaid