Provider Demographics
NPI:1053206003
Name:KOHL, SARAH CHARLOTTE (RN)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:CHARLOTTE
Last Name:KOHL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 E 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74112-4232
Mailing Address - Country:US
Mailing Address - Phone:479-367-1470
Mailing Address - Fax:
Practice Address - Street 1:401 E BROADWAY CT
Practice Address - Street 2:
Practice Address - City:SAND SPRINGS
Practice Address - State:OK
Practice Address - Zip Code:74063-7939
Practice Address - Country:US
Practice Address - Phone:479-367-1470
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK215105163W00000X, 163WP0808X
NY957353-01163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse