Provider Demographics
NPI:1841307279
Name:COCHRAN, LISA HELENE (FNP-C)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:HELENE
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:HELENE
Other - Last Name:CRIMALDI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:13430 N SCOTTSDALE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-4058
Mailing Address - Country:US
Mailing Address - Phone:888-407-7928
Mailing Address - Fax:
Practice Address - Street 1:13430 N SCOTTSDALE RD STE 200
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-4058
Practice Address - Country:US
Practice Address - Phone:888-407-7928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ083291363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZQ55278Medicare UPIN
AZ106338Medicare ID - Type UnspecifiedMEDICARE #
AZ910069Medicare ID - Type UnspecifiedAHCCCS #