Provider Demographics
NPI:1003997818
Name:COCHRAN, MARLO LUCILLE (WHCNP)
Entity Type:Individual
Prefix:
First Name:MARLO
Middle Name:LUCILLE
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:
Other - First Name:MARLO
Other - Middle Name:LUCILLE
Other - Last Name:JASEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHCNP
Mailing Address - Street 1:6431 FANNIN ST # 3.286
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-6412
Mailing Address - Fax:
Practice Address - Street 1:6410 FANNIN ST STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3004
Practice Address - Country:US
Practice Address - Phone:832-325-7131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2019-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX604115363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health