Individual
LORI DENELL HAWKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3 SAINT ELIZABETH BLVD, O FALLON, IL 62269-1281
(618) 641-5803
Mailing address
3 SAINT ELIZABETH BLVD, O FALLON, IL 62269-1281
(618) 641-5803
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2023038671
MO
363L00000X
Nurse Practitioner
Primary
209024612
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1760267736
—
IL
Enumeration date
08/29/2023
Last updated
02/16/2026
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