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NPI Code Detail

MEDICARE: MRS. JODI KATHERINE COCKERHAM ARNP, FNP-C

MEDICARE: MRS. JODI KATHERINE COCKERHAM ARNP, FNP-C
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
1363LA2100XAcute Care Nurse Practitioner21322SC
2363LF0000XFamily Nurse Practitioner9221153FL

General Provider Information

NPI Number : 1568997492
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JODI KATHERINE COCKERHAM ARNP, FNP-C
Provider Business Mailing Address
First Line : 2836 AUGUSTA RD
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29170-3323
Country : US
Telephone Number : 803-939-0545
Fax Number :
Provider Business Practice Location Address
First Line : 2836 AUGUSTA RD
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29170-3323
Country : US
Telephone Number : 813-469-1141
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2017
Last Update Date : 10/22/2018

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Directions to “ MRS. JODI KATHERINE COCKERHAM ARNP, FNP-C” Practice Location

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