Healthcare Provider Details

I. General information

NPI: 1184342438
Provider Name (Legal Business Name): DEBRA KIM COCHRAN IP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2022
Last Update Date: 08/22/2022
Certification Date: 08/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 CONNETT RD
THE PLAINS OH
45780-1432
US

IV. Provider business mailing address

8 CONNETT RD
THE PLAINS OH
45780-1432
US

V. Phone/Fax

Practice location:
  • Phone: 740-331-0806
  • Fax:
Mailing address:
  • Phone: 740-331-0806
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License NumberNA
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: