Provider Demographics
NPI:1003515990
Name:COCKERHAM, DELINDA (FNP-C)
Entity Type:Individual
Prefix:
First Name:DELINDA
Middle Name:
Last Name:COCKERHAM
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3557 HIGHWAY 156
Mailing Address - Street 2:
Mailing Address - City:WINNFIELD
Mailing Address - State:LA
Mailing Address - Zip Code:71483-7735
Mailing Address - Country:US
Mailing Address - Phone:318-332-6085
Mailing Address - Fax:
Practice Address - Street 1:560 GUM SPRINGS ROAD
Practice Address - Street 2:
Practice Address - City:WINNFIELD
Practice Address - State:LA
Practice Address - Zip Code:71483
Practice Address - Country:US
Practice Address - Phone:318-628-3971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA229239363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner