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General NPI Number Information
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NPI Number | 1982408167
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Entity Type | Individual
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Provider Name | JORDAN COCHRAN
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Gender | Female
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Dates
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Enumeration Date | 04/04/2025
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 73015 HIGHWAY 25 STE A
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City | COVINGTON
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State | LA
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Zip | 70435-5694
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Country | US
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Telephone | 985-400-5370
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Fax |
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Provider Business Mailing Address
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Address Line | 26315 PALE ALE CT
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City | PONCHATOULA
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State | LA
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Zip | 70454-4263
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Country | US
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Telephone | 228-493-2061
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 200088
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License Number State | LA
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