Individual
TRACI L CARRIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
115 S LINCOLN ST., MANGUM, OK 73554
(866) 926-6552
Mailing address
115 S LINCOLN ST., MANGUM, OK 73554
(806) 205-3887
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
65825
OK
Other
Enumeration date
01/30/2019
Last updated
01/30/2019
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