Provider Demographics
NPI:1467671685
Name:BROWN, BETSY COCHRAN (RN)
Entity Type:Individual
Prefix:MRS
First Name:BETSY
Middle Name:COCHRAN
Last Name:BROWN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2128
Mailing Address - Country:US
Mailing Address - Phone:410-859-0607
Mailing Address - Fax:
Practice Address - Street 1:330 OAK MANOR DR
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-5509
Practice Address - Country:US
Practice Address - Phone:410-222-6435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR069193163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR069193Medicare UPIN