Provider Demographics
NPI:1336739291
Name:HAWKINS, AMELIA RUTH (RN, APRN)
Entity Type:Individual
Prefix:
First Name:AMELIA
Middle Name:RUTH
Last Name:HAWKINS
Suffix:
Gender:F
Credentials:RN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 YORKTOWN ST
Mailing Address - Street 2:
Mailing Address - City:WAGONER
Mailing Address - State:OK
Mailing Address - Zip Code:74467-3554
Mailing Address - Country:US
Mailing Address - Phone:918-513-2306
Mailing Address - Fax:
Practice Address - Street 1:1325 E 15TH ST STE 205
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74120-5851
Practice Address - Country:US
Practice Address - Phone:918-300-4939
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-24
Last Update Date:2023-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK205331363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily