Individual
LACEY NICOLE RUTZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
109 N FAIRLAND ST, PRYOR, OK 74361-4205
(918) 825-1405
Mailing address
109 N FAIRLAND ST, PRYOR, OK 74361-4205
(918) 825-1405
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R0125858
OK
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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