Healthcare Provider Details

I. General information

NPI: 1649198672
Provider Name (Legal Business Name): FORSHE RAEON TRAYLOR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 N ROCKWELL AVE
OKLAHOMA CITY OK
73132-5849
US

IV. Provider business mailing address

7400 N ROCKWELL AVE APT 4208
OKLAHOMA CITY OK
73132-5857
US

V. Phone/Fax

Practice location:
  • Phone: 405-551-1307
  • Fax:
Mailing address:
  • Phone: 405-551-1307
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: