Provider Demographics
NPI:1144462961
Name:COHICK, BECKY LYNN (LPN)
Entity type:Individual
Prefix:
First Name:BECKY
Middle Name:LYNN
Last Name:COHICK
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13350 TRACY RD
Mailing Address - Street 2:
Mailing Address - City:ALBION
Mailing Address - State:PA
Mailing Address - Zip Code:16401-8314
Mailing Address - Country:US
Mailing Address - Phone:814-756-0498
Mailing Address - Fax:
Practice Address - Street 1:13350 TRACY RD
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:PA
Practice Address - Zip Code:16401-8314
Practice Address - Country:US
Practice Address - Phone:814-756-0498
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 129574164W00000X
PAPN277792164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse