Provider Demographics
NPI:1568061364
Name:COCHRAN, JAMIE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2208 VIA LUNA
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32789-1369
Mailing Address - Country:US
Mailing Address - Phone:407-963-4339
Mailing Address - Fax:
Practice Address - Street 1:2208 VIA LUNA
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32789-1369
Practice Address - Country:US
Practice Address - Phone:407-963-4339
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11008113363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily