Provider Demographics
NPI:1154970549
Name:HOCKETT, CONNIE JEAN
Entity type:Individual
Prefix:MRS
First Name:CONNIE
Middle Name:JEAN
Last Name:HOCKETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:JEAN
Other - Last Name:ATKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:303 COUNTY RD 159
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75669-2603
Mailing Address - Country:US
Mailing Address - Phone:903-263-7389
Mailing Address - Fax:
Practice Address - Street 1:303 COUNTY RD 159
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75669-2603
Practice Address - Country:US
Practice Address - Phone:903-263-7389
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-09
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider