Provider Demographics
NPI:1710864814
Name:ANDERSON, KAYLA PEARL COX (DPH)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:PEARL COX
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:740 HEATHER TER
Mailing Address - Street 2:
Mailing Address - City:YUKON
Mailing Address - State:OK
Mailing Address - Zip Code:73099-3314
Mailing Address - Country:US
Mailing Address - Phone:405-205-0298
Mailing Address - Fax:
Practice Address - Street 1:9000 S MAY AVE
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73159-6602
Practice Address - Country:US
Practice Address - Phone:405-691-1148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-19
Last Update Date:2025-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK21038183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist