1114987898 NPI number — DAWN COCKRELL LM CPM

Table of content: (NPI 1114987898)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114987898 NPI number — DAWN COCKRELL LM CPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAWN COCKRELL LM CPM
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1114987898
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3602 S COUNTY ROAD 1309
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ODESSA
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79765-9656
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
432-563-3297
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3602 SCR 1309
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ODESSA
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79765-9656
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
432-563-3297
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/25/2006

Additional Information

Authorized Official

Authorized Official Last Name:
COCKRELL
Authorized Official First Name:
DAWN
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
LICENSED MIDWIFE, ADMINISTRATOR
Authorized Official Telephone Number:
432-563-3297

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  01010 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 174400000X , with the licence number: 04001R , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 176B00000X , with the licence number: 02030019 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 176B00000X , with the licence number: 04001R , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261Q00000X , with the licence number: 008332 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QB0400X , with the licence number: 008332 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QF0050X , with the licence number: 008332 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 176B00000X , with the licence number: 01010 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 008332 . This is a "LICENSED BIRTHING CENTER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 04001R . This is a "PRACTITIONER LICENSE #" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 02030019 . This is a "CPM NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 02030019 . This is a "NARM CERTIFIED LICENSE #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 01010 . This is a "PRACTITIONER LICENSE #" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 04001R . This is a "LICENSED MIDWIFE" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 008332 . This is a "FACILITY LICENSE NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 01010 . This is a "LICENSED MIDWIFE" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 1114987898 . This is a "FACILITY NPI NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com