Provider Demographics
NPI:1295749463
Name:COCHRANE - HOEKSTRA, DANA JO (PA)
Entity type:Individual
Prefix:MS
First Name:DANA
Middle Name:JO
Last Name:COCHRANE - HOEKSTRA
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:131 W SEAWAY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:NORTON SHORES
Mailing Address - State:MI
Mailing Address - Zip Code:49444-3759
Mailing Address - Country:US
Mailing Address - Phone:231-375-8065
Mailing Address - Fax:231-375-8063
Practice Address - Street 1:131 W SEAWAY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:NORTON SHORES
Practice Address - State:MI
Practice Address - Zip Code:49444-3759
Practice Address - Country:US
Practice Address - Phone:231-375-8065
Practice Address - Fax:231-375-8063
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5601003695363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5601003695OtherSTATE LISCENSE