Provider Demographics
NPI:1629670518
Name:COCHRANE, PRECIOUS DESTINE
Entity Type:Individual
Prefix:
First Name:PRECIOUS
Middle Name:DESTINE
Last Name:COCHRANE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3943 RILEY AVE
Mailing Address - Street 2:
Mailing Address - City:STRUTHERS
Mailing Address - State:OH
Mailing Address - Zip Code:44471-1829
Mailing Address - Country:US
Mailing Address - Phone:330-261-8517
Mailing Address - Fax:
Practice Address - Street 1:3943 RILEY AVE
Practice Address - Street 2:
Practice Address - City:STRUTHERS
Practice Address - State:OH
Practice Address - Zip Code:44471-1829
Practice Address - Country:US
Practice Address - Phone:330-261-8517
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-15
Last Update Date:2020-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide