Basic Information
Provider Information
NPI: 1699399691
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAWKINS
FirstName: CHARTEYE
MiddleName:  
NamePrefix: MRS.
NameSuffix:  
Credential: APRN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1200 7TH AVE N
Address2:  
City: ST PETERSBURG
State: FL
PostalCode: 337051300
CountryCode: US
TelephoneNumber: 7278251100
FaxNumber:  
Practice Location
Address1: 1200 7TH AVE N
Address2:  
City: ST PETERSBURG
State: FL
PostalCode: 337051300
CountryCode: US
TelephoneNumber: 7278251100
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/04/2020
LastUpdateDate: 09/08/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/08/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X9321416FLN Nursing Service ProvidersRegistered Nurse 
363LP0808XAPRN11007505FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsych/Mental Health

No ID Information.


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