Provider Demographics
NPI:1760936033
Name:HAWKINS-PRATT, STACI (NP)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:
Last Name:HAWKINS-PRATT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 LANDMARK CIR
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73507-9008
Mailing Address - Country:US
Mailing Address - Phone:580-351-7538
Mailing Address - Fax:
Practice Address - Street 1:1411 W 12TH AVE STE E
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-5482
Practice Address - Country:US
Practice Address - Phone:405-338-7707
Practice Address - Fax:405-533-3132
Is Sole Proprietor?:No
Enumeration Date:2016-08-04
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX905334363LF0000X
OK99437363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily