Healthcare Provider Details

I. General information

NPI: 1437579828
Provider Name (Legal Business Name): ANDREA COCHRAN APN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2014
Last Update Date: 02/21/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 HADDONFIELD BERLIN RD
VOORHEES NJ
08043-3714
US

IV. Provider business mailing address

205 E LAUREL RD
STRATFORD NJ
08084-1301
US

V. Phone/Fax

Practice location:
  • Phone: 856-857-6920
  • Fax: 856-429-3826
Mailing address:
  • Phone: 856-344-2415
  • Fax: 856-344-2315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number26NJ004888000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License NumberSP013735
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: