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Individual

LINDA COCKRELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
703 FARMER ST, PORT GIBSON, MS 39150-2319
(601) 437-3037
(601) 437-4315
Mailing address
703 FARMER ST, PORT GIBSON, MS 39150-2319
(601) 437-3037
(601) 437-4315

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R747936
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
04983840
MS
05
1034827
LA
01
202011213A
BLUE CROSS
MS
Enumeration date
06/15/2006
Last updated
07/29/2008
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