Healthcare Provider Details

I. General information

NPI: 1851717581
Provider Name (Legal Business Name): TERRI COBB BHRS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2014
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 W BROADWAY ST
MUSKOGEE OK
74401-3340
US

IV. Provider business mailing address

113 W KEETOOWAH ST
TAHLEQUAH OK
74464-3819
US

V. Phone/Fax

Practice location:
  • Phone: 918-681-4201
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: