Provider Demographics
NPI:1154094373
Name:COCHRAN, SARA BETH (APRN)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:BETH
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:BETH
Other - Last Name:WIMSATT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN
Mailing Address - Street 1:411 E CHESTNUT ST FL 6
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40202-1713
Mailing Address - Country:US
Mailing Address - Phone:502-588-3650
Mailing Address - Fax:502-588-7852
Practice Address - Street 1:411 E CHESTNUT ST FL 6
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40202-1713
Practice Address - Country:US
Practice Address - Phone:502-588-3650
Practice Address - Fax:502-588-7852
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71011460A363LF0000X
KY3015629363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily