Healthcare Provider Details

I. General information

NPI: 1710814892
Provider Name (Legal Business Name): JENNIFER COCHRAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2026
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 N PRINCE ST
LANCASTER PA
17603-3010
US

IV. Provider business mailing address

410 N PRINCE ST
LANCASTER PA
17603-3010
US

V. Phone/Fax

Practice location:
  • Phone: 717-560-7917
  • Fax: 717-754-0299
Mailing address:
  • Phone: 717-560-7917
  • Fax: 717-754-0299

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number96390
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: