Individual
AMANDA COCILOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
970 LAKELAND DR STE 61, JACKSON, MS 39216-4634
(601) 982-7850
(601) 366-8507
Mailing address
970 LAKELAND DR STE 61, JACKSON, MS 39216-4634
(601) 982-7850
(601) 366-8507
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R886569
MS
Other
Enumeration date
09/10/2014
Last updated
04/16/2024
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