Provider Demographics
NPI:1851610448
Name:HAWKINS, MELISSA JOANNE (RN, ARNP, CPNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JOANNE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:RN, ARNP, CPNP
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:BOWLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, ARNP, CPNP
Mailing Address - Street 1:3691 RUTGER AVE
Mailing Address - Street 2:
Mailing Address - City:ST. LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2515
Mailing Address - Country:US
Mailing Address - Phone:314-977-6828
Mailing Address - Fax:314-977-6872
Practice Address - Street 1:1465 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1003
Practice Address - Country:US
Practice Address - Phone:314-268-4101
Practice Address - Fax:314-577-5379
Is Sole Proprietor?:No
Enumeration Date:2010-05-23
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK77335363LP0200X
MO2010034956363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics