Provider Demographics
NPI:1477727170
Name:HAWKINS, LAKISHA YVETTE (MD)
Entity Type:Individual
Prefix:
First Name:LAKISHA
Middle Name:YVETTE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4180 S. RAINBOW BLVD. STE 809
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89103
Mailing Address - Country:US
Mailing Address - Phone:702-383-3626
Mailing Address - Fax:702-227-8487
Practice Address - Street 1:4180 S. RAINBOW BLVD. STE 809
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89103
Practice Address - Country:US
Practice Address - Phone:702-383-3626
Practice Address - Fax:702-227-8487
Is Sole Proprietor?:No
Enumeration Date:2008-04-15
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV14021207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1477727170Medicaid