Provider Demographics
NPI:1790770675
Name:HAWKINS, JULIE (ARNP)
Entity Type:Individual
Prefix:MS
First Name:JULIE
Middle Name:
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:ODOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:215 N KANSAS ST
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-5443
Mailing Address - Country:US
Mailing Address - Phone:580-774-4710
Mailing Address - Fax:580-774-0964
Practice Address - Street 1:215 N KANSAS ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-5443
Practice Address - Country:US
Practice Address - Phone:580-774-4710
Practice Address - Fax:580-774-0964
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2015-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0058220363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK248510902Medicare ID - Type UnspecifiedMEDICARE