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Individual

MARY E. PAUZAUSKIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
3208 MEDICAL PARK DR, SHAWNEE, OK 74804-5014
(405) 878-7160
(405) 878-7149
Mailing address
1102 W MACARTHUR ST, SHAWNEE, OK 74804-1743
(405) 273-2270
(405) 878-7129

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
61320
OK
364S00000X
Clinical Nurse Specialist
R0061320
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200049550A
OK
05
200049550B
OK
Enumeration date
05/12/2006
Last updated
10/21/2014
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