Jackie Lynn Hawkinson, SPTA

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

G087026331215 Issued in MN

Practice address

6008 Goodrich Ave
Saint Louis Park, MN 55416-2425

Phone

(612) 578-0502

NPI assigned

Jan 29, 2013

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1578801346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6008 GOODRICH AVE",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162425",
            "telephone_number": "612-578-0502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6008 GOODRICH AVE",
            "city": "SAINT LOUIS PARK",
            "state": "MN",
            "postal_code": "554162425",
            "telephone_number": "612-578-0502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAWKINSON",
        "first_name": "JACKIE",
        "middle_name": "LYNN",
        "credential": "SPTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-01-29",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MN",
            "license": "G087026331215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Auralie Haven, LICSW
• Taylor Rose Havens, FNP-BC
• Jason Havey
• Faye Marie Hawes, P.T.
• Heather M Hawkinson, OTR/L
• Jonathan Power Hawkinson
• Christina Marie Hawn, DPT
• Nancy Hayer, MS-CCC-SLP
• Dana Lynn Hayes, MA CCC-SLP
• Kelly Jane Hayes

• Student in an Organized Health Care Education/Training Program in Saint Louis Park, MN
• Providers in Saint Louis Park, MN by specialty
• Student in an Organized Health Care Education/Training Program in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.