Provider Demographics
NPI:1285237255
Name:COCHRAN, NANCY A
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:A
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 WOODSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:OH
Mailing Address - Zip Code:45036-7796
Mailing Address - Country:US
Mailing Address - Phone:513-238-8490
Mailing Address - Fax:
Practice Address - Street 1:317 WOODSTONE WAY
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:OH
Practice Address - Zip Code:45036-7796
Practice Address - Country:US
Practice Address - Phone:513-238-8490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-20
Last Update Date:2020-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH83051403747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH8305140Medicaid