Provider Demographics
NPI:1346624921
Name:HAWLEY, KARISSA (CNM)
Entity Type:Individual
Prefix:
First Name:KARISSA
Middle Name:
Last Name:HAWLEY
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 E MANSION ST
Mailing Address - Street 2:SUITE 3D
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1559
Mailing Address - Country:US
Mailing Address - Phone:269-781-1183
Mailing Address - Fax:
Practice Address - Street 1:215 E MANSION ST
Practice Address - Street 2:SUITE 3D
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1559
Practice Address - Country:US
Practice Address - Phone:269-781-1183
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-14
Last Update Date:2020-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife