Individual
MELISSA HAWK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PHN
Contact information
Practice address
5219 SAINT JOHN DR, ORR, MN 55771-8232
(218) 757-3650
Mailing address
5219 SAINT JOHN DR, ORR, MN 55771-8232
(218) 757-3650
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2279428
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2279428
STATE LICENSE
MN
01
—
28117
STATE LICENSE
MN
Enumeration date
07/09/2020
Last updated
07/09/2020
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