Individual
TRACY LEE FOSTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10512 N 110TH EAST AVE, OWASSO, OK 74055
(918) 376-8410
Mailing address
10512 N 110TH EAST AVE, OWASSO, OK 74055-6636
(918) 289-3945
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
66957
OK
363LF0000X
Family Nurse Practitioner
Primary
66957
OK
Other
Enumeration date
03/20/2018
Last updated
07/14/2018
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