Cockrell, Kimberly J

Cockrell, Kimberly J is an individual health care provider with primary practice located at 400 1St Capitol Dr Suite 201, Saint Charles MO 63301-2880. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Cockrell, Kimberly J can be contacted via phone (636) 669-2332.

Contact Information

Primary practice address
400 1St Capitol Dr Suite 201 Saint Charles MO 63301-2880
Phone: (636) 669-2332
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 2015025661 Missouri

Profile Details

NPI number 1649648890
LBN Legal business name Cockrell, Kimberly J
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 4th, 2015
Last updated Nov 19th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1649648890 NPPES
Missouri Other 2015025661 NP LICENSE

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