Provider Demographics
NPI:1104217017
Name:HANKINS, ALISIA CHEVESE (DNP, NNP-BC, IBCLC)
Entity type:Individual
Prefix:
First Name:ALISIA
Middle Name:CHEVESE
Last Name:HANKINS
Suffix:
Gender:F
Credentials:DNP, NNP-BC, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 KRISTEN CV
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-6641
Mailing Address - Country:US
Mailing Address - Phone:662-230-3008
Mailing Address - Fax:
Practice Address - Street 1:5 RIVER BEND PL STE C
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-7618
Practice Address - Country:US
Practice Address - Phone:601-957-7345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-13
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR887920363LN0000X, 163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS04000084Medicaid
MS401940YS8TMedicare PIN