Individual
TRACI A OWEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, CSC, SE
Contact information
Practice address
2297 N 9TH ST STE 121, BROKEN ARROW, OK 74012-2890
(918) 283-7130
(539) 367-2412
Mailing address
2297 N 9TH ST STE 121, BROKEN ARROW, OK 74012-2890
(918) 283-7130
(539) 367-2412
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0051306
OK
Other
Enumeration date
02/18/2022
Last updated
02/18/2022
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