Provider Demographics
NPI:1891037859
Name:COCKRELL, JULIA M (RN)
Entity Type:Individual
Prefix:
First Name:JULIA
Middle Name:M
Last Name:COCKRELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1095 COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSTON
Mailing Address - State:SC
Mailing Address - Zip Code:29832-2731
Mailing Address - Country:US
Mailing Address - Phone:803-275-1997
Mailing Address - Fax:803-275-1783
Practice Address - Street 1:1095 COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:SC
Practice Address - Zip Code:29832-2731
Practice Address - Country:US
Practice Address - Phone:803-275-1997
Practice Address - Fax:803-275-1783
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-18
Last Update Date:2013-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251300000XAgenciesLocal Education Agency (LEA)