Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Grace Jean Fornwalt, MHR, ATC, LAT, CES

Individual provider Athletic Trainer · NPI 1518520931

Grace Jean Fornwalt, MHR, ATC, LAT, CES is an Athletic Trainer in Norman, Oklahoma. Licensed in Missouri, Oklahoma and Texas. Registered with an NPI since 2019.

Licensed in
MO, OK, TX
In the registry since
2019
Specialties on file
3
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
LAT — Licensed Athletic Trainer
A state-licensed athletic trainer.

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Practice location Address checks out

375 Triad Village Dr Unit 14
Norman, OK 73071-2896
Phone: (314) 753-6506
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Athletic Trainer (primary) Taxonomy 2255A2300X · Licence 987 (OK)
Athletic Trainer Taxonomy 2255A2300X · Licence 2015032686 (MO)
Athletic Trainer Taxonomy 2255A2300X (TX)

Record details

NPI number1518520931
Entity typeIndividual (Type 1)
GenderFemale
Credentials MHR , ATC , LAT , CES
Sole proprietorNo
NPI enumeratedApril 22, 2019
Last updated in NPPESApril 22, 2019

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