Provider Demographics
NPI:1962405100
Name:COCHRAN, ELAINE K (CRNP)
Entity type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:K
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:12007 TITIAN WAY
Mailing Address - Street 2:
Mailing Address - City:POTOMAC
Mailing Address - State:MD
Mailing Address - Zip Code:20854-3345
Mailing Address - Country:US
Mailing Address - Phone:240-753-9065
Mailing Address - Fax:301-480-3368
Practice Address - Street 1:NIH NIDDK DEOB 10 CENTER DRIVE CRC 6 5940
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20892-0001
Practice Address - Country:US
Practice Address - Phone:301-496-2718
Practice Address - Fax:301-480-3368
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-23
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDR119905363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDMC1619521OtherDEA