Healthcare Provider Details

I. General information

NPI: 1639839079
Provider Name (Legal Business Name): MERLINDA HAWKINS DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/27/2021
Last Update Date: 03/07/2023
Certification Date: 03/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 SAMARITAN DR
LAS CRUCES NM
88001-1170
US

IV. Provider business mailing address

2550 SAMARITAN DR
LAS CRUCES NM
88001-1170
US

V. Phone/Fax

Practice location:
  • Phone: 575-386-5778
  • Fax: 575-680-2812
Mailing address:
  • Phone: 575-386-5778
  • Fax: 575-680-2812

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number65837
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: