Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 771115 | TX |
N | 363LA2100X | Nurse Practitioner - Acute Care | 97764 | OK |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 771115 | TX |
N | 363LF0000X | Nurse Practitioner - Family Medicine | 97764 | OK |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | AP128979 | TX |
NPI | 1003284068 |
---|---|
Provider Name | Carla Ann Cochran |
First Address | Denison, TX 75020-1553 |
Second Address | Denison, TX 75020-1553 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2015 |
Last Update Date | 04/01/2019 |