Provider Demographics
NPI:1912494097
Name:COCHRAN, STEPHANIE K (CNA)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:K
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 S NORTON ST
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IN
Mailing Address - Zip Code:46952-3296
Mailing Address - Country:US
Mailing Address - Phone:765-664-0101
Mailing Address - Fax:765-668-8391
Practice Address - Street 1:317 S NORTON ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:IN
Practice Address - Zip Code:46952-3296
Practice Address - Country:US
Practice Address - Phone:765-664-0101
Practice Address - Fax:765-668-8391
Is Sole Proprietor?:No
Enumeration Date:2018-04-16
Last Update Date:2018-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INCNA1101183376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide