Provider Demographics
NPI:1023796620
Name:HAWKINS, DE MISHA YANETT (RN)
Entity type:Individual
Prefix:
First Name:DE MISHA
Middle Name:YANETT
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1552
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-8552
Mailing Address - Country:US
Mailing Address - Phone:903-376-8717
Mailing Address - Fax:
Practice Address - Street 1:6646 W. FUQUA
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77489-5937
Practice Address - Country:US
Practice Address - Phone:903-376-8717
Practice Address - Fax:281-499-8062
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X, 251J00000X, 343900000X, 385H00000X
TX699462163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251J00000XAgenciesNursing Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty