Provider Demographics
NPI:1356884514
Name:COCHRAN, RHONDA
Entity type:Individual
Prefix:MS
First Name:RHONDA
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:RHONDA
Other - Middle Name:M
Other - Last Name:COCHRAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:18422 SYRACUSE ST
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48234-2520
Mailing Address - Country:US
Mailing Address - Phone:586-339-2221
Mailing Address - Fax:
Practice Address - Street 1:18422 SYRACUSE ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48234-2520
Practice Address - Country:US
Practice Address - Phone:586-339-2221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704208426163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse