MEDICARE: GEORGIA COCKERHAM

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1861347585
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGIA COCKERHAM

Provider Business Mailing Address
First Line	:	1515 DEMONBREUN ST APT 422
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203-4581
Country	:	US
Telephone Number	:	662-436-5008
Fax Number	:

Provider Business Practice Location Address
First Line	:	6900 LENOX VILLAGE DR STE 14
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37211-7366
Country	:	US
Telephone Number	:	615-864-8990
Fax Number	:

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

Provider Enumeration Date	:	02/27/2026
Last Update Date	:	02/27/2026

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Directions to “ GEORGIA COCKERHAM ” Practice Location

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