Provider Demographics
NPI:1396634788
Name:COCHRAN, CHRISTIA
Entity type:Individual
Prefix:
First Name:CHRISTIA
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17263 WESTPHALIA ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48205-3187
Mailing Address - Country:US
Mailing Address - Phone:313-685-5726
Mailing Address - Fax:
Practice Address - Street 1:17263 WESTPHALIA ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48205-3187
Practice Address - Country:US
Practice Address - Phone:313-685-5726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIMI000054462251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health