Provider Demographics
NPI:1619127990
Name:COCHRAN, D HEATHEREEN (NP)
Entity Type:Individual
Prefix:
First Name:D HEATHEREEN
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 N ORANGE AVE STE 689
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32804-4648
Mailing Address - Country:US
Mailing Address - Phone:407-303-2024
Mailing Address - Fax:
Practice Address - Street 1:2501 N ORANGE AVE STE 689
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32804-4648
Practice Address - Country:US
Practice Address - Phone:407-303-2024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704204702363LA2200X
FLARNP9318168363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health