Provider Demographics
NPI:1346012689
Name:REED, COCO (ACMA, CNA)
Entity Type:Individual
Prefix:MS
First Name:COCO
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:ACMA, CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3619 S LAKEWOOD AVE APT B
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74135-5746
Mailing Address - Country:US
Mailing Address - Phone:918-291-9945
Mailing Address - Fax:
Practice Address - Street 1:3619 S LAKEWOOD AVE APT B
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-5746
Practice Address - Country:US
Practice Address - Phone:918-291-9945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK37V628921015376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty