Provider Demographics
NPI:1669502498
Name:HAWLEY, DIANE JUANITA (RN)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:JUANITA
Last Name:HAWLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:JUANITA
Other - Last Name:DAUSSES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:173 RAINBOW DRIVE
Mailing Address - Street 2:#7364
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77399-1073
Mailing Address - Country:US
Mailing Address - Phone:661-747-4795
Mailing Address - Fax:
Practice Address - Street 1:173 RAINBOW DR
Practice Address - Street 2:#7364
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77399-0001
Practice Address - Country:US
Practice Address - Phone:661-747-4795
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX109426163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health