Provider Demographics
NPI:1740050053
Name:HAWKINS, CODI NICOLE (APRN)
Entity type:Individual
Prefix:MRS
First Name:CODI
Middle Name:NICOLE
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 JOHN ASHLEY DR
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72114-1825
Mailing Address - Country:US
Mailing Address - Phone:501-683-1406
Mailing Address - Fax:501-683-5732
Practice Address - Street 1:2401 JOHN ASHLEY DR
Practice Address - Street 2:
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72114-1825
Practice Address - Country:US
Practice Address - Phone:501-683-1406
Practice Address - Fax:501-683-5732
Is Sole Proprietor?:No
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA006145363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily