Individual
SHELLEY S COCHRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2117 BROADWAY DRIVE, HATTIESBURG, MS 39402-3210
(601) 288-8050
(601) 288-8058
Mailing address
2117 BROADWAY DRIVE, HATTIESBURG, MS 39402-3210
(601) 288-8050
(601) 288-8058
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R854943
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06130899
—
MS
05
—
891010090
—
AL
Enumeration date
08/22/2006
Last updated
06/05/2025
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