Individual
TRACY SUE OGDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1908 N 14TH ST STE 205, PONCA CITY, OK 74601-2039
(580) 718-4532
Mailing address
1908 N 14TH ST STE 205, PONCA CITY, OK 74601-2039
(580) 718-4532
(580) 540-3016
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
93682
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200270850A
—
OK
Enumeration date
09/17/2009
Last updated
09/16/2020
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