Provider Demographics
NPI:1851125033
Name:COCKFIELD, MYESHA (LPN)
Entity type:Individual
Prefix:
First Name:MYESHA
Middle Name:
Last Name:COCKFIELD
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103-105 EARLE ST
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06120
Mailing Address - Country:US
Mailing Address - Phone:860-993-8836
Mailing Address - Fax:
Practice Address - Street 1:511 E COLUMBUS AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01105-2506
Practice Address - Country:US
Practice Address - Phone:413-923-6747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-29
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALN99887164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse