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NPI 1396746897

NPI 1396746897 : DEAN J COCHRANE CRNA : COON RAPIDS, MN

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General NPI Number Information
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    NPI Number           |    1396746897
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    Entity Type          |    Individual 
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    Provider Name        |    DEAN J COCHRANE CRNA
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    08/09/2005
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    Last Update Date     |    05/15/2008
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Provider Practice Location Address
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    Address Line         |    8990 SPRINGBROOK DR NW SUITE 250
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    City                 |    COON RAPIDS
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    State                |    MN
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    Zip                  |    55433-5850
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    Country              |    US
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    Telephone            |    763-398-0099
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    Fax                  |    763-398-0124
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Provider Business Mailing Address
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    Address Line         |    4125 BALSAM LN N 
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    City                 |    PLYMOUTH
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    State                |    MN
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    Zip                  |    55441-1452
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    367500000X
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    Taxonomy Name        |    Certified Registered Nurse Anesthetist
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    License Number       |    R1351509
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    License Number State |    MN
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