Provider Demographics
NPI:1710484159
Name:COCHRAN, KATY IRENE (FNP)
Entity Type:Individual
Prefix:
First Name:KATY
Middle Name:IRENE
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5232 COLLEYVILLE BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7827
Mailing Address - Country:US
Mailing Address - Phone:817-912-9920
Mailing Address - Fax:817-912-8301
Practice Address - Street 1:5232 COLLEYVILLE BLVD STE 100
Practice Address - Street 2:
Practice Address - City:COLLEYVILLE
Practice Address - State:TX
Practice Address - Zip Code:76034-7827
Practice Address - Country:US
Practice Address - Phone:817-912-9920
Practice Address - Fax:817-912-8301
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2023-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX730275163W00000X
TXAP138367363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP138367OtherFNP-BC