Individual
TAMMY LEIGH COCOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
825 FAIRFAX AVE STE 310, NORFOLK, VA 23507-1914
(757) 446-7979
(757) 446-8907
Mailing address
PO BOX 936, NORFOLK, VA 23501-0936
(757) 446-7979
(757) 446-8907
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110003345
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1023395233
MULTIPLAN
—
05
—
1023395233
—
VA
Enumeration date
11/16/2011
Last updated
06/08/2017
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