Provider Demographics
NPI:1174957369
Name:O'DONNELL, KYNSIE ELAINE COCHRAN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:KYNSIE
Middle Name:ELAINE COCHRAN
Last Name:O'DONNELL
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:812 SNOW ST
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-3533
Mailing Address - Country:US
Mailing Address - Phone:931-607-1731
Mailing Address - Fax:
Practice Address - Street 1:3569 BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37411-2708
Practice Address - Country:US
Practice Address - Phone:423-629-7323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-24
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN37812183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist