Organization
TJ3AM3
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE L HAWKINS RN (R.N. SOLE PROPRIETOR)
(601) 638-6262
Entity
Organization
Contact information
Practice address
104 GREENVIEW DR, VICKSBURG, MS 39183-9003
(601) 638-6262
Mailing address
104 GREENVIEW DR, VICKSBURG, MS 39183-9003
(601) 638-6262
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
R870313
MS
251G00000X
Community Based Hospice Care Agency
R870313
MS
Other
Enumeration date
03/28/2008
Last updated
03/28/2008
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