Provider Demographics
NPI:1912197567
Name:COCHRAN, KARI LYNN
Entity Type:Individual
Prefix:
First Name:KARI
Middle Name:LYNN
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KARI
Other - Middle Name:LYNN
Other - Last Name:PARKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1421 OAKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-4446
Mailing Address - Country:US
Mailing Address - Phone:405-383-3967
Mailing Address - Fax:
Practice Address - Street 1:300 WANDA ST
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OK
Practice Address - Zip Code:73448-1200
Practice Address - Country:US
Practice Address - Phone:580-276-3347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1611363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200123520AMedicaid
OK1611OtherLICENSE