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General NPI Number Information
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NPI Number | 1336739291
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Entity Type | Individual
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Provider Name | AMELIA RUTH HAWKINS RN, APRN
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Gender | Female
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Dates
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Enumeration Date | 01/24/2021
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Last Update Date | 04/30/2023
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Provider Practice Location Address
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Address Line | 1325 E 15TH ST STE 205
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City | TULSA
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State | OK
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Zip | 74120-5851
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Country | US
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Telephone | 918-300-4939
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Fax |
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Provider Business Mailing Address
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Address Line | 414 YORKTOWN ST
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City | WAGONER
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State | OK
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Zip | 74467-3554
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Country | US
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Telephone | 918-513-2306
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 205331
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License Number State | OK
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