Provider Information for 1689336596
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TRACI TRIPLETT
Sex: Female
NPI: 1689336596
Last Updated: 2024-10-15
Certification Date: 2024-10-15
Certification Date: 2024-10-15
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1689336596 | ||||||||
| Enumeration Date | 2021-10-07 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | NO | ||||||||
| Status | Active | ||||||||
| Mailing Address | 4704 S LINWOOD DR SAND SPRINGS, OK 74063-3128 United States Phone: 918-804-0684 | Fax: | ||||||||
| Primary Practice Address | 1334 N LANSING AVE TULSA, OK 74106-5907 United States Phone: 918-587-2171 | Fax: | ||||||||
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