Provider Demographics
NPI:1093038473
Name:COCHRAN, ANNETTE MARIE (RN)
Entity type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:MARIE
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3571 CHEROKEE DR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OR
Mailing Address - Zip Code:97478-6345
Mailing Address - Country:US
Mailing Address - Phone:541-747-8089
Mailing Address - Fax:
Practice Address - Street 1:3571 CHEROKEE DR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OR
Practice Address - Zip Code:97478-6345
Practice Address - Country:US
Practice Address - Phone:541-747-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-12
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR080012148RN374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide