Healthcare Provider Details

I. General information

NPI: 1487411161
Provider Name (Legal Business Name): PAULA RENEE HAWTHORNE PRSS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/29/2024
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4900 E FRANK PHILLIPS BLVD
BARTLESVILLE OK
74006-8521
US

IV. Provider business mailing address

4900 E FRANK PHILLIPS BLVD
BARTLESVILLE OK
74006-8521
US

V. Phone/Fax

Practice location:
  • Phone: 918-384-0002
  • Fax:
Mailing address:
  • Phone: 918-384-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: