Healthcare Provider Details

I. General information

NPI: 1841696630
Provider Name (Legal Business Name): LAUREN HAYMANS PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 11/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 E ROBINSON ST
NORMAN OK
73071-6610
US

IV. Provider business mailing address

DEPT 96-0341
OKLAHOMA CITY OK
73196-0341
US

V. Phone/Fax

Practice location:
  • Phone: 405-364-7900
  • Fax: 405-364-6719
Mailing address:
  • Phone: 405-705-5925
  • Fax: 405-341-9217

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number2474
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: