Healthcare Provider Details

I. General information

NPI: 1689531485
Provider Name (Legal Business Name): LYDIA NICOLE HATFIELD BSN, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 HONOR HEIGHTS DR
MUSKOGEE OK
74401-1318
US

IV. Provider business mailing address

5918 W HILTON RD
SAPULPA OK
74066-1155
US

V. Phone/Fax

Practice location:
  • Phone: 888-397-8387
  • Fax:
Mailing address:
  • Phone: 918-706-8443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number200142
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number200142
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number200142
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: