Healthcare Provider Details

I. General information

NPI: 1962323741
Provider Name (Legal Business Name): LASHAWN COCHRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19706 CLIFF ST
DETROIT MI
48234-4615
US

IV. Provider business mailing address

19706 CLIFF ST
DETROIT MI
48234-4615
US

V. Phone/Fax

Practice location:
  • Phone: 313-603-8718
  • Fax:
Mailing address:
  • Phone: 313-603-8718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number4703130251
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: