Healthcare Provider Details

I. General information

NPI: 1528744273
Provider Name (Legal Business Name): ELIZABETH COCHRAN MEADOWS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH COCHRAN PMHNP-BC

II. Dates (important events)

Enumeration Date: 06/27/2023
Last Update Date: 11/27/2023
Certification Date: 11/27/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5804 1ST AVE S
BIRMINGHAM AL
35212-2524
US

IV. Provider business mailing address

4634 WOODDALE LN
PELHAM AL
35124-1020
US

V. Phone/Fax

Practice location:
  • Phone: 205-380-9455
  • Fax:
Mailing address:
  • Phone: 205-566-9255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number1-180673
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number1-180673
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: