Individual
MRS. GWENDOLYN D HARRIS-COCROFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
605 STADIUM DR, HATTIESBURG, MS 39401-4156
(601) 450-0310
(601) 450-0321
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-3700
(601) 450-2493
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R859966
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07474202
—
MS
Enumeration date
03/31/2011
Last updated
02/04/2013
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