Provider Demographics
NPI:1710972302
Name:COCHRAN, PAMELA LEE (MSN,CNP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:LEE
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:MSN,CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 LAKESIDE E AVE 1000
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44114-1162
Mailing Address - Country:US
Mailing Address - Phone:440-984-1546
Mailing Address - Fax:216-420-9354
Practice Address - Street 1:600 KENDAL DR
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074-1900
Practice Address - Country:US
Practice Address - Phone:440-775-9819
Practice Address - Fax:440-775-9854
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH06485363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHP46614Medicare UPIN
OHCONP09386Medicare PIN