Provider Demographics
NPI:1255664405
Name:COCHRANE, JENNIFER S (PA-C)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:S
Last Name:COCHRANE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2478 NASHVILLE HWY STE A
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:TN
Mailing Address - Zip Code:38401-0634
Mailing Address - Country:US
Mailing Address - Phone:931-398-6590
Mailing Address - Fax:931-398-6597
Practice Address - Street 1:2478 NASHVILLE HWY STE A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-0634
Practice Address - Country:US
Practice Address - Phone:931-398-6590
Practice Address - Fax:931-398-6597
Is Sole Proprietor?:No
Enumeration Date:2009-09-04
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA20480363AM0700X
TN5054363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00785467OtherRAILROAD MEDICARE
CAP00785467OtherRAILROAD MEDICARE
CAMC2025092OtherDEA