Provider Demographics
NPI:1700645140
Name:ISAACS-COCHRAN, MCKINLEY BROOKE (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:MCKINLEY
Middle Name:BROOKE
Last Name:ISAACS-COCHRAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:739 BLUFF CITY HWY STE 3
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:TN
Mailing Address - Zip Code:37620-4637
Mailing Address - Country:US
Mailing Address - Phone:423-804-1208
Mailing Address - Fax:423-804-1208
Practice Address - Street 1:739 BLUFF CITY HWY STE 3
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-4637
Practice Address - Country:US
Practice Address - Phone:423-534-9195
Practice Address - Fax:423-844-0360
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN257386163W00000X
TN36088363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse