Individual
KIMBERLY J COCKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
400 1ST CAPITOL DR, SUITE 201, SAINT CHARLES, MO 63301-2880
(636) 669-2332
Mailing address
PO BOX 955534, SAINT LOUIS, MO 63195-5534
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2015025661
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2015025661
NP LICENSE
MO
Enumeration date
09/04/2015
Last updated
11/19/2020
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