Provider Demographics
NPI:1851623771
Name:HAWKINS, MELISSA ANN (RPH)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANN
Other - Last Name:GOODHART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8350 S RIVER PKWY
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85284-2615
Mailing Address - Country:US
Mailing Address - Phone:480-752-8200
Mailing Address - Fax:
Practice Address - Street 1:21051 SHERMAN WAY
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-1746
Practice Address - Country:US
Practice Address - Phone:818-348-6222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-02
Last Update Date:2021-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA73861183500000X
PARP044101L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist