Provider Demographics
NPI:1568803906
Name:COCHRAN, SYDNEY (MS, RD, LD)
Entity Type:Individual
Prefix:
First Name:SYDNEY
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1125 WESTPORT DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-3026
Mailing Address - Country:US
Mailing Address - Phone:785-251-8685
Mailing Address - Fax:785-670-8408
Practice Address - Street 1:1125 WESTPORT DR
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502-3026
Practice Address - Country:US
Practice Address - Phone:785-251-8685
Practice Address - Fax:785-670-8408
Is Sole Proprietor?:No
Enumeration Date:2013-07-15
Last Update Date:2017-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1847133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered