Provider Demographics
NPI:1962087650
Name:SMELLEY, CATHERINE COCHRAN
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:COCHRAN
Last Name:SMELLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CATHERINE
Other - Middle Name:ELISE
Other - Last Name:COCHRAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:416 N SEMINARY ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-4688
Mailing Address - Country:US
Mailing Address - Phone:256-766-8667
Mailing Address - Fax:
Practice Address - Street 1:416 N SEMINARY ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-4688
Practice Address - Country:US
Practice Address - Phone:256-766-8667
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-14
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL180-666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily