Healthcare Provider Details

I. General information

NPI: 1184675399
Provider Name (Legal Business Name): MARY E. PAUZAUSKIE ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY ELIZABETH OZAN CNS

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 10/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3208 MEDICAL PARK DR
SHAWNEE OK
74804-5014
US

IV. Provider business mailing address

1102 W MACARTHUR ST
SHAWNEE OK
74804-1743
US

V. Phone/Fax

Practice location:
  • Phone: 405-878-7160
  • Fax: 405-878-7149
Mailing address:
  • Phone: 405-273-2270
  • Fax: 405-878-7129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberR0061320
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number61320
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: