Individual
MRS. TRISA SUE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
10288 E 263RD ST S, PORUM, OK 74455-5639
(918) 681-0141
Mailing address
10288 E 263RD ST S, PORUM, OK 74455-5639
(918) 681-0141
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
R0104933
OK
Other
Enumeration date
07/01/2025
Last updated
07/01/2025
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