Provider Demographics
NPI:1710020813
Name:HAWKS-BAUGH, JULIE M (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:M
Last Name:HAWKS-BAUGH
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1753 N ROOSEVELT ST
Mailing Address - Street 2:
Mailing Address - City:GUYMON
Mailing Address - State:OK
Mailing Address - Zip Code:73942-2763
Mailing Address - Country:US
Mailing Address - Phone:580-338-7792
Mailing Address - Fax:580-338-7797
Practice Address - Street 1:1753 N ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:GUYMON
Practice Address - State:OK
Practice Address - Zip Code:73942-2763
Practice Address - Country:US
Practice Address - Phone:580-338-7792
Practice Address - Fax:580-338-7797
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2020-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO103872363LF0000X
OKR0061081363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO425380219Medicaid
OK425380219Medicaid
OK823324211Medicare Oscar/Certification
OKP38695Medicare UPIN
MO823324211Medicare ID - Type UnspecifiedGP 000014211
MOP38695Medicare UPIN