Individual
MS. STACIE MADELINE COCKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
5074 KERNSVILLE RD, OREFIELD, PA 18069-2350
(610) 395-1993
(610) 395-2516
Mailing address
2100 MACK BLVD FL 4, ALLENTOWN, PA 18103-5622
(484) 884-0469
(484) 884-0628
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
03894
MI
363A00000X
Physician Assistant
5601003894
MI
363AM0700X
Medical Physician Assistant
Primary
MA059210
PA
Other
Enumeration date
06/30/2006
Last updated
02/05/2018
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