Provider Demographics
NPI:1740261320
Name:COCHRANE, JANICE H (FNP)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:H
Last Name:COCHRANE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:JANICE
Other - Middle Name:BALES
Other - Last Name:HOFFMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:12192 AUGUSTA ROAD
Mailing Address - Street 2:
Mailing Address - City:LAVONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30553-1209
Mailing Address - Country:US
Mailing Address - Phone:706-356-1072
Mailing Address - Fax:706-356-1457
Practice Address - Street 1:12192 AUGUSTA ROAD
Practice Address - Street 2:
Practice Address - City:LAVONIA
Practice Address - State:GA
Practice Address - Zip Code:30553-1209
Practice Address - Country:US
Practice Address - Phone:706-356-1072
Practice Address - Fax:706-356-1457
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042368363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000973761FMedicaid
GAP86823Medicare UPIN