Provider Demographics
NPI:1285360149
Name:COCKERHAM, CYNTHIA T (RN)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:T
Last Name:COCKERHAM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:T
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:216 FOUNTAIN CT STE 250
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-2510
Mailing Address - Country:US
Mailing Address - Phone:859-276-5008
Mailing Address - Fax:859-278-6401
Practice Address - Street 1:216 FOUNTAIN CT STE 250
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-2510
Practice Address - Country:US
Practice Address - Phone:859-276-5008
Practice Address - Fax:859-278-6401
Is Sole Proprietor?:No
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1147752163WX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0800XNursing Service ProvidersRegistered NurseOrthopedic