Provider Demographics
NPI:1063205904
Name:KOK, YAR
Entity type:Individual
Prefix:
First Name:YAR
Middle Name:
Last Name:KOK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9018 FORT ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68134-1749
Mailing Address - Country:US
Mailing Address - Phone:616-648-0768
Mailing Address - Fax:
Practice Address - Street 1:339 FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-1247
Practice Address - Country:US
Practice Address - Phone:616-648-0768
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-23
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide