Individual
TRACI STEWART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
106 HOWARD ST, POCOLA, OK 74902-3523
(918) 564-2217
Mailing address
472555 E 1070 RD, MULDROW, OK 74948-6683
(479) 353-1528
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
206033
OK
Other
Enumeration date
01/31/2022
Last updated
01/31/2022
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