Healthcare Provider Details

I. General information

NPI: 1306695622
Provider Name (Legal Business Name): KATHERINE ANNE COCKS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2024
Last Update Date: 05/17/2024
Certification Date: 05/17/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9828 NE 23RD ST
OKLAHOMA CITY OK
73141-4208
US

IV. Provider business mailing address

9828 NE 23RD ST
OKLAHOMA CITY OK
73141-4208
US

V. Phone/Fax

Practice location:
  • Phone: 405-769-2551
  • Fax: 405-769-6255
Mailing address:
  • Phone: 405-769-2551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License NumberR49667
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberR49667
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: