Healthcare Provider Details

I. General information

NPI: 1336822030
Provider Name (Legal Business Name): TRACY PARKER
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/09/2023
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 N PORTER AVE
NORMAN OK
73071-6404
US

IV. Provider business mailing address

3300 HEALTHPLEX PKWY
NORMAN OK
73072-9749
US

V. Phone/Fax

Practice location:
  • Phone: 405-307-7900
  • Fax:
Mailing address:
  • Phone: 405-515-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number214214
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: