Provider Demographics
NPI:1174647309
Name:CHERIAN, SAKARIAH M (ARNP-BC)
Entity Type:Individual
Prefix:MR
First Name:SAKARIAH
Middle Name:M
Last Name:CHERIAN
Suffix:
Gender:M
Credentials:ARNP-BC
Other - Prefix:MR
Other - First Name:ZACH
Other - Middle Name:M
Other - Last Name:CHERIAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP-BC
Mailing Address - Street 1:14625 REMINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-1804
Mailing Address - Country:US
Mailing Address - Phone:405-748-4084
Mailing Address - Fax:405-748-4084
Practice Address - Street 1:14625 REMINGTON WAY
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-1804
Practice Address - Country:US
Practice Address - Phone:405-748-4084
Practice Address - Fax:405-748-4084
Is Sole Proprietor?:No
Enumeration Date:2007-03-16
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2006010073363LF0000X
OKR 0064466363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKOK401646Medicare PIN