Provider Demographics
NPI:1881027555
Name:HAWKINS, AMY JO (CNP)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:JO
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:JO
Other - Last Name:KROEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3301 MERCY HEALTH BLVD STE 125
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-1106
Mailing Address - Country:US
Mailing Address - Phone:513-215-9200
Mailing Address - Fax:513-215-9259
Practice Address - Street 1:3301 MERCY HEALTH BLVD STE 125
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-1106
Practice Address - Country:US
Practice Address - Phone:513-215-9200
Practice Address - Fax:513-215-9259
Is Sole Proprietor?:No
Enumeration Date:2013-08-16
Last Update Date:2018-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71005582A363LA2100X
OH14942363LA2100X
OHAPRN.CNP.023544363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0089939Medicaid
OHH246820Medicare PIN
INM400074282Medicare PIN