Provider Demographics
NPI:1831702174
Name:HAWES, MARY KATHERINE (DNP, FNP-C)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:KATHERINE
Last Name:HAWES
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5434 S DUNROBIN DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65809-4602
Mailing Address - Country:US
Mailing Address - Phone:417-631-8822
Mailing Address - Fax:
Practice Address - Street 1:1000 CARONDELET DR STE 100
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-4673
Practice Address - Country:US
Practice Address - Phone:816-941-9030
Practice Address - Fax:816-941-4416
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020016208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty