Individual
TRACI DAWN GILLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
900 E MAIN ST, NORMAN, OK 73071-5305
(405) 307-4839
Mailing address
407 N TAYLOR AVE, WYNNEWOOD, OK 73098-4630
(903) 818-3663
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
0119242
OK
Other
Enumeration date
05/15/2017
Last updated
05/15/2017
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