Provider Demographics
NPI:1619478898
Name:COCKSON, BROOKE ELIZABETH (MS, RDN, LDN)
Entity type:Individual
Prefix:MRS
First Name:BROOKE
Middle Name:ELIZABETH
Last Name:COCKSON
Suffix:
Gender:F
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:ELIZABETH
Other - Last Name:BIERMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1013 SAGO PALM WAY
Mailing Address - Street 2:
Mailing Address - City:APOLLO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33572
Mailing Address - Country:US
Mailing Address - Phone:719-287-6243
Mailing Address - Fax:888-977-1798
Practice Address - Street 1:1013 SAGO PALM WAY
Practice Address - Street 2:
Practice Address - City:APOLLO BEACH
Practice Address - State:FL
Practice Address - Zip Code:33572
Practice Address - Country:US
Practice Address - Phone:719-287-6243
Practice Address - Fax:888-977-1798
Is Sole Proprietor?:No
Enumeration Date:2018-02-23
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX89939133V00000X
WA61251808133V00000X
IL164.010824133V00000X
OR10247221133V00000X
MT123479133V00000X
174H00000X
FL10769133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174H00000XOther Service ProvidersHealth Educator