Individual
MRS. KATHLEEN MARIE BOCKHOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, ARNP-BC
Contact information
Practice address
1365 W BRIERBROOK RD, GERMANTOWN, TN 38138-2208
(662) 349-9990
(662) 349-2620
Mailing address
122 AIRWAYS PL, SOUTHAVEN, MS 38671-5872
(662) 349-9990
(662) 349-2620
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
A810342
MS
363LA2200X
Adult Health Nurse Practitioner
Primary
5965
TN
Other
Enumeration date
04/16/2008
Last updated
09/15/2010
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