Provider Demographics
NPI:1386845469
Name:HAWKINS, LINDA GALE (FNP NC)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:GALE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:FNP NC
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:G
Other - Last Name:HORNE HAWKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:751 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:NATCHEZ
Mailing Address - State:MS
Mailing Address - Zip Code:39120
Mailing Address - Country:US
Mailing Address - Phone:601-304-4352
Mailing Address - Fax:
Practice Address - Street 1:15 CAMPUS DR
Practice Address - Street 2:
Practice Address - City:NATCHEZ
Practice Address - State:MS
Practice Address - Zip Code:39120
Practice Address - Country:US
Practice Address - Phone:601-304-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR648264363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01025061Medicaid