Maricruz Haines, APRN

Individual provider Active NPI Nurse Practitioner · Guymon, OK

NPI 1457066458 · NPPES record last updated Apr 1, 2025

Key facts

NPI
1457066458
Entity type
Individual (NPI type 1)
Primary specialty
Nurse Practitioner 363L00000X
License
221870 (OK)
Practice address
123 Medical Dr
Guymon, OK 73942-3606
Phone
(580) 338-3361
Fax
(580) 338-1021
NPI assigned
Jan 16, 2023
Sex
Female
Sole proprietor
No

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Southwest Medical Center (62 clinicians)

Practice addresses (Care Compare)

123 Medical Dr
Guymon, OK 73942-3606
Phone (580) 338-3361

Hospital & facility affiliations

  • Southwest Medical Center Hospital · Liberal, KS · CCN 170068
  • Memorial Hospital of Texas County Authority Hospital · Guymon, OK · CCN 371340

Medicare participation

Medicare fee-for-service enrollment
Enrolled in OK
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20250704000364 OK Practitioner - Nurse Practitioner 0446764203 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southwest Medical Center Current
since Apr 11, 2025
Accepting new patients
Southwest Medical Center Current
since Apr 11, 2025
Accepting new patients
Southwest Medical Center Past Accepting new patients

Locations

421 Medical Dr
Guymon, OK 73942
Phone (580) 338-3135

123 Medical Dr
Guymon, OK 73942
Phone (580) 338-3361

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Nurse Practitioner 363L00000X 221870 OK Yes

Addresses

Primary practice location

123 Medical Dr
Guymon, OK 73942-3606

Mailing address

1700 SW College Ave
Topeka, KS 66621-0001

Other names

  • Maricruz Headrick Former name

Other providers in Guymon, OK

All providers in Guymon, OK · Nurse Practitioner in Oklahoma

Sources for this page

Verify at the official NPI Registry.