Healthcare Provider Details

I. General information

NPI: 1548938335
Provider Name (Legal Business Name): HALEY A COCHRAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HALEY AHNA KOHN

II. Dates (important events)

Enumeration Date: 09/06/2021
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 DIPLOMACY DR
ANCHORAGE AK
99508-5925
US

IV. Provider business mailing address

261 N ROOSEVELT AVE
CHANDLER AZ
85226-2617
US

V. Phone/Fax

Practice location:
  • Phone: 907-729-3300
  • Fax:
Mailing address:
  • Phone: 480-677-8282
  • Fax: 888-316-1686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number11830
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number205371
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: