MEDICARE: MRS. CHELSEA LEIGH COCKRELL AGACNP-BC, FNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	903356	MS
2	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	MD33077	AL

General Provider Information

NPI Number	:	1447804463
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHELSEA LEIGH COCKRELL AGACNP-BC, FNP-BC

Provider Business Mailing Address
First Line	:	778 LIBERTY RD
Second Line	:
City	:	FLOWOOD
State	:	MS
Zip	:	39232-9300
Country	:	US
Telephone Number	:	769-239-3793
Fax Number	:	601-477-2236

Provider Business Practice Location Address
First Line	:	1190 N STATE ST STE 2A
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39202-2413
Country	:	US
Telephone Number	:	769-243-6141
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/29/2019
Last Update Date	:	05/26/2026

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