MEDICARE: TRACY RANAE BELL I

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1235796368
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TRACY RANAE BELL I

Provider Business Mailing Address
First Line	:	3871 W LAKE RD
Second Line	:
City	:	FORT TOWSON
State	:	OK
Zip	:	74735-5600
Country	:	US
Telephone Number	:	580-433-2098
Fax Number	:

Provider Business Practice Location Address
First Line	:	3871 W LAKE RD
Second Line	:
City	:	FORT TOWSON
State	:	OK
Zip	:	74735-5600
Country	:	US
Telephone Number	:	580-433-2098
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2019
Last Update Date	:	05/23/2019

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Directions to “ TRACY RANAE BELL I ” Practice Location

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