Healthcare Provider Details

I. General information

NPI: 1003754532
Provider Name (Legal Business Name): LESA TRICKETT RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2026
Last Update Date: 03/24/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 HONOR HEIGHTS DR
MUSKOGEE OK
74401-1318
US

IV. Provider business mailing address

310 E BK RD 1204 UNIT A
STIGLER OK
74462
US

V. Phone/Fax

Practice location:
  • Phone: 918-577-3546
  • Fax:
Mailing address:
  • Phone: 918-577-3546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License NumberRC366
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: