| NPI | 1619499860 |
|---|---|
| Former Name | BRENNA LEIGH HAWKINS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 5247) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2085531) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2018-01-03 |