Provider Demographics
NPI:1265710164
Name:COCKRELL, JAMIE NICHOLE (CRNP)
Entity type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:NICHOLE
Last Name:COCKRELL
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:422 E DR HICKS BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-5707
Mailing Address - Country:US
Mailing Address - Phone:256-766-1401
Mailing Address - Fax:256-766-1402
Practice Address - Street 1:422 E DR HICKS BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-5707
Practice Address - Country:US
Practice Address - Phone:256-766-1401
Practice Address - Fax:256-766-1402
Is Sole Proprietor?:No
Enumeration Date:2011-07-26
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL1-087729364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care