MEDICARE: MR. SAKARIAH M CHERIAN ARNP-BC

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	363LF0000X	Family Nurse Practitioner	2006010073	OK
2	363LF0000X	Family Nurse Practitioner	R 0064466	OK

General Provider Information

NPI Number	:	1174647309
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SAKARIAH M CHERIAN ARNP-BC

Provider Business Mailing Address
First Line	:	14625 REMINGTON WAY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-1804
Country	:	US
Telephone Number	:	405-748-4084
Fax Number	:	405-748-4084

Provider Business Practice Location Address
First Line	:	14625 REMINGTON WAY
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-1804
Country	:	US
Telephone Number	:	405-748-4084
Fax Number	:	405-748-4084

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

Provider Enumeration Date	:	03/16/2007
Last Update Date	:	02/03/2009

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