Provider Demographics
NPI:1114906831
Name:COCHRAN, JENNIFER VAN NOY (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:VAN NOY
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 S GREEN RD
Mailing Address - Street 2:SUITE #035
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-4128
Mailing Address - Country:US
Mailing Address - Phone:216-382-3800
Mailing Address - Fax:216-381-5198
Practice Address - Street 1:1611 S GREEN RD
Practice Address - Street 2:SUITE #035
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4128
Practice Address - Country:US
Practice Address - Phone:216-382-3800
Practice Address - Fax:216-381-5198
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH701882080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine