Healthcare Provider Details

I. General information

NPI: 1891243515
Provider Name (Legal Business Name): LAUREN COCHRAN PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2016
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1530 N 7TH ST STE 107
TERRE HAUTE IN
47807-1057
US

IV. Provider business mailing address

2700 COLLETT WOODS LN
TERRE HAUTE IN
47804-1100
US

V. Phone/Fax

Practice location:
  • Phone: 812-232-0564
  • Fax: 812-242-3861
Mailing address:
  • Phone: 870-275-1602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number10002110A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: