Individual
MRS. SUSAN COCKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1105 BURLEYSON RD, DALTON, GA 30720-3017
(706) 278-4640
(706) 275-6599
Mailing address
1105 BURLEYSON RD, DALTON, GA 30720-3017
(706) 278-4640
(706) 275-6599
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
R052096
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00367661A
—
GA
Enumeration date
01/30/2007
Last updated
07/09/2007
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