Provider Demographics
NPI:1265188890
Name:WOMEN'S COMPREHENSIVE CARE LLC
Entity type:Organization
Organization Name:WOMEN'S COMPREHENSIVE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:KAI
Authorized Official - Middle Name:
Authorized Official - Last Name:HAWKINS
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNM, WHNP
Authorized Official - Phone:562-739-6688
Mailing Address - Street 1:2410 MCCONNELL CIR APT H12
Mailing Address - Street 2:
Mailing Address - City:WHITE HALL
Mailing Address - State:AR
Mailing Address - Zip Code:71602-3334
Mailing Address - Country:US
Mailing Address - Phone:562-739-6688
Mailing Address - Fax:
Practice Address - Street 1:1301 RIDGWAY RD STE 1B
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-7610
Practice Address - Country:US
Practice Address - Phone:870-917-4355
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Single Specialty