Provider Demographics
NPI:1508096595
Name:POCHAN, SHAWNA (CNM, MPH)
Entity Type:Individual
Prefix:MS
First Name:SHAWNA
Middle Name:
Last Name:POCHAN
Suffix:
Gender:F
Credentials:CNM, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:216 W TRINITY AVE
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-1917
Mailing Address - Country:US
Mailing Address - Phone:206-799-5609
Mailing Address - Fax:
Practice Address - Street 1:105 NEWSOM ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704
Practice Address - Country:US
Practice Address - Phone:919-286-2872
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-23
Last Update Date:2018-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168414367A00000X
NC659367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife