Provider Demographics
NPI:1477340321
Name:COCKRELL, HEIDI R (LPN)
Entity type:Individual
Prefix:
First Name:HEIDI
Middle Name:R
Last Name:COCKRELL
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 SWARTZ RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-1328
Mailing Address - Country:US
Mailing Address - Phone:951-423-5597
Mailing Address - Fax:
Practice Address - Street 1:480 SWARTZ RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-1328
Practice Address - Country:US
Practice Address - Phone:951-423-5597
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.089839.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse