Healthcare Provider Details

I. General information

NPI: 1184038499
Provider Name (Legal Business Name): ASHLEY COCILOVA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEY KITTRELL ALLEN

II. Dates (important events)

Enumeration Date: 06/13/2014
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 STONE CREEK BLVD STE 500
FLOWOOD MS
39232-8210
US

IV. Provider business mailing address

120 STONE CREEK BLVD SUITE 500
FLOWOOD MS
39232-8205
US

V. Phone/Fax

Practice location:
  • Phone: 601-420-2040
  • Fax:
Mailing address:
  • Phone: 662-588-0947
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR882220
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: