Individual
TRACY MAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1908 N 14TH ST STE 104, PONCA CITY, OK 74601-2049
(580) 765-0212
(580) 763-0873
Mailing address
3001 QUAIL SPRINGS PKWY FL 5, OKLAHOMA CITY, OK 73134-2640
(580) 765-0212
(580) 763-0873
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
09312
OK
363LP0200X
Pediatric Nurse Practitioner
Primary
R0090312
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200674180A
—
OK
Enumeration date
07/22/2015
Last updated
04/30/2026
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