Healthcare Provider Details

I. General information

NPI: 1730853821
Provider Name (Legal Business Name): RACHEL JILLIAN TRUONG APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2021
Last Update Date: 12/22/2025
Certification Date: 12/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 NW EXPRESSWAY
OKLAHOMA CITY OK
73112-4999
US

IV. Provider business mailing address

19553 BIG CEDAR DR
CASHION OK
73016-9503
US

V. Phone/Fax

Practice location:
  • Phone: 405-613-3351
  • Fax:
Mailing address:
  • Phone: 405-919-9230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number205120
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberR0117499
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: