Provider Demographics
NPI:1245239912
Name:COCHRAN, ASHLEY (FNP)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 NORTH LAKEWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:LAKE IN THE HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60156-5945
Mailing Address - Country:US
Mailing Address - Phone:224-569-4000
Mailing Address - Fax:877-686-5642
Practice Address - Street 1:170 N LAKEWOOD RD
Practice Address - Street 2:
Practice Address - City:LAKE IN THE HILLS
Practice Address - State:IL
Practice Address - Zip Code:60156-5944
Practice Address - Country:US
Practice Address - Phone:224-569-4000
Practice Address - Fax:877-686-5642
Is Sole Proprietor?:No
Enumeration Date:2005-07-15
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209005458363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400345925Medicare UPIN
ILK16112Medicare PIN
ILK16111Medicare PIN