Cockburn, Susan
Cockburn, Susan is an individual health care provider with primary practice located at 1105 Burleyson Rd , Dalton GA 30720-3017. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife, which is considered as her primary health care specialty. Cockburn, Susan can be contacted via phone (706) 278-4640.Contact Information
Primary practice address
1105 Burleyson Rd
Dalton GA 30720-3017
Phone: (706) 278-4640
Fax: (706) 275-6599
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Advanced Practice Midwife | 367A00000X | R052096 | Georgia |
Profile Details
| NPI number | 1194861435 |
|---|---|
| LBN Legal business name | Cockburn, Susan |
| Credentials | Certified Nurse Midwife (CNM) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 30th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194861435 | NPPES |
| Georgia | MEDICAID | 00367661A |
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