Provider Demographics
NPI:1770877821
Name:COCHRAN, STEPHANIE MEGAN (APN)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:MEGAN
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
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Mailing Address - Street 1:965 RIDGE LAKE BLVD STE 315
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38120-9401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:901-227-8591
Practice Address - Street 1:7715 WOLF RIVER BLVD
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:TN
Practice Address - Zip Code:38138
Practice Address - Country:US
Practice Address - Phone:901-328-6031
Practice Address - Fax:901-328-6035
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN15670363L00000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner