Individual
DAVID MICHAEL RACKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
2701 W UNIVERSITY BLVD, DURANT, OK 74701-2997
(580) 740-4053
Mailing address
13130 SW 13TH ST, YUKON, OK 73099-6368
(405) 831-6692
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
R0112063
OK
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R0112063
OK
Other
Enumeration date
10/31/2020
Last updated
07/22/2021
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