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General NPI Number Information
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NPI Number | 1104161405
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Entity Type | Individual
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Provider Name | YASHICA NAKIYA HAWKINS ANP
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Gender | Female
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Dates
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Enumeration Date | 11/28/2012
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Last Update Date | 08/25/2022
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Provider Practice Location Address
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Address Line | 8229 CLAYTON RD STE 202
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1155
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Country | US
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Telephone | 314-473-5661
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Fax |
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Provider Business Mailing Address
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Address Line | 8229 CLAYTON RD STE 202
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City | SAINT LOUIS
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State | MO
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Zip | 63117-1155
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Country | US
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Telephone | 314-473-5661
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2012022147
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | ARNP9454295
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 77949
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 2012022147
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License Number State | MO
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