Provider Demographics
NPI:1912583477
Name:COCHRAN, SHAWNA (CP-C)
Entity type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:CP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 STOCKTRAIL AVE
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82716-3554
Mailing Address - Country:US
Mailing Address - Phone:307-688-1160
Mailing Address - Fax:
Practice Address - Street 1:502 STOCKTRAIL AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3554
Practice Address - Country:US
Practice Address - Phone:307-688-1160
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYP107926146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic