| NPI | 1083914261 | 
|---|---|
| Former Name | KORTNI R COKELY | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: AZ 7414) | 
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: MI 5601005908) | 
| Enumeration Date | 2010-10-22 | 
| Last Update Date | 2024-10-17 |