Provider Demographics
NPI:1194296657
Name:CAHON, ODESSIA ANN
Entity type:Individual
Prefix:
First Name:ODESSIA
Middle Name:ANN
Last Name:CAHON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10804 QUAIL PLAZA DR STE 500
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-3113
Mailing Address - Country:US
Mailing Address - Phone:405-905-0500
Mailing Address - Fax:405-751-6960
Practice Address - Street 1:10804 QUAIL PLAZA DR STE 500
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-3113
Practice Address - Country:US
Practice Address - Phone:405-905-0500
Practice Address - Fax:405-751-6960
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-10
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKHC8083251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health