Individual
DOMONIQUE NIKKI COCHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
7001 HWY 614, HURLEY, MS 39555
(228) 588-2938
(228) 588-9399
Mailing address
PO BOX 850, HURLEY, MS 39555-0850
(228) 588-2938
(228) 588-9399
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R854690
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09336715
—
MS
Enumeration date
12/29/2011
Last updated
05/02/2022
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