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Tracy Dinah Long

Nurse's Aide in Oklahoma City, OK. Individual provider (NPI-1).

NPI number1669902128
StatusActive
Last updated in NPPESJun 18, 2017

Details

NPI
1669902128
Entity type
Individual (NPI-1)
Name
Tracy Dinah Long
Sex
Female
Sole proprietor
Yes
Enumeration date
Jun 18, 2017
Last updated
Jun 18, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
376K00000X Nurse's Aide37V239421202OKYes

Practice location

2629 W I 44 Service Rd Ste 202
Oklahoma City, OK 73112-3762

Phone 405-605-1865

Mailing address

2120 Sw 84th St
Oklahoma City, OK 73159-6102

Phone 405-505-6205

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