MEDICARE: MRS. LYDIA NICOLE HATFIELD BSN, RN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0200X	Critical Care Medicine Registered Nurse	200142	OK

General Provider Information

NPI Number	:	1689531485
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYDIA NICOLE HATFIELD BSN, RN

Provider Business Mailing Address
First Line	:	5918 W HILTON RD
Second Line	:
City	:	SAPULPA
State	:	OK
Zip	:	74066-1155
Country	:	US
Telephone Number	:	918-706-8443
Fax Number	:

Provider Business Practice Location Address
First Line	:	1011 HONOR HEIGHTS DR
Second Line	:
City	:	MUSKOGEE
State	:	OK
Zip	:	74401-1318
Country	:	US
Telephone Number	:	888-397-8387
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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