Individual
HAWA CISSOKHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
17178 ELM TRAIL DR, EUREKA, MO 63025-2344
(636) 628-6785
Mailing address
1717 INDUSTRIAL DR, JEFFERSON CITY, MO 65109-1468
(573) 358-5516
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2024088847
MO
Other
Enumeration date
11/04/2024
Last updated
05/21/2025
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