Lori Denell Hawkins, NP | |
1191 Fortune Blvd Ste 2, Shiloh, IL 62269-7474 | |
(618) 607-0061 | |
Not Available |
Full Name | Lori Denell Hawkins |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Location | 1191 Fortune Blvd Ste 2, Shiloh, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1760267736 | NPI | - | NPPES |
1760267736 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 2023038671 (Missouri) | Secondary |
363L00000X | Nurse Practitioner | 209024612 (Illinois) | Primary |
Entity Name | Mitas Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1659967917 PECOS PAC ID: 1355745316 Enrollment ID: O20210812002429 |
Mailing Address | Practice Location Address |
---|---|
Lori Denell Hawkins, NP 1191 Fortune Blvd Ste 2, Shiloh, IL 62269-7474 Ph: (618) 607-0061 | Lori Denell Hawkins, NP 1191 Fortune Blvd Ste 2, Shiloh, IL 62269-7474 Ph: (618) 607-0061 |
Danielle Lynn Frueh, FNP-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1170 Fortune Blvd, Shiloh, IL 62269 Phone: 618-997-5266 | |
Gaylin Manion, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1167 Fortune Blvd, Shiloh, IL 62269 Phone: 618-207-6900 Fax: 618-207-6901 | |
Christina Marie Weibley, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1170 Fortune Blvd, Shiloh, IL 62269 Phone: 618-997-5266 Fax: 833-431-2272 | |
Ms. Kayce Justine Bourgette, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1418 Cross St, Div Im Medical Oncology, Ste 180, Shiloh, IL 62269 Phone: 800-647-2098 Fax: 618-622-9724 | |
Kristy Wienstroer, WHNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1191 Fortune Blvd, Shiloh, IL 62269 Phone: 618-206-6101 | |
Katy Helene Wine, MSN, FNP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1414 Cross St Ste 240, Shiloh, IL 62269 Phone: 618-234-2390 Fax: 618-234-9936 | |
Ki Ristia J Allen-lampe, APN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1116 Hartman Ln, Shiloh, IL 62221 Phone: 618-641-9011 Fax: 618-641-9017 |