Healthcare Provider Details

I. General information

NPI: 1932022183
Provider Name (Legal Business Name): RAQUETTA VEAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5404 SW LEE BLVD
LAWTON OK
73505-9521
US

IV. Provider business mailing address

PO BOX 6344
LAWTON OK
73506-0344
US

V. Phone/Fax

Practice location:
  • Phone: 580-355-5242
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number229826
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: