Provider Demographics
NPI:1104102961
Name:GRATCH, LUCI ANN (ARNP)
Entity type:Individual
Prefix:MS
First Name:LUCI
Middle Name:ANN
Last Name:GRATCH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1211 N SHARTEL AVE
Mailing Address - Street 2:SUITE 700
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-2400
Mailing Address - Country:US
Mailing Address - Phone:405-702-6700
Mailing Address - Fax:405-702-6718
Practice Address - Street 1:1211 N SHARTEL AVE
Practice Address - Street 2:SUITE 700
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-2400
Practice Address - Country:US
Practice Address - Phone:405-702-6700
Practice Address - Fax:405-702-6718
Is Sole Proprietor?:No
Enumeration Date:2011-10-25
Last Update Date:2014-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKR0081057363LA2100X
OK81057363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care