Provider Demographics
NPI:1184342438
Name:COCHRAN, DEBRA KIM (IP)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:KIM
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:IP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 CONNETT RD
Mailing Address - Street 2:
Mailing Address - City:THE PLAINS
Mailing Address - State:OH
Mailing Address - Zip Code:45780-1432
Mailing Address - Country:US
Mailing Address - Phone:740-331-0806
Mailing Address - Fax:
Practice Address - Street 1:8 CONNETT RD
Practice Address - Street 2:
Practice Address - City:THE PLAINS
Practice Address - State:OH
Practice Address - Zip Code:45780-1432
Practice Address - Country:US
Practice Address - Phone:740-331-0806
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-22
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNA251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health