Provider Demographics
NPI:1366790644
Name:COCHRAN, MICHELLE (FNP)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 SPRING ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-2735
Mailing Address - Country:US
Mailing Address - Phone:301-565-0914
Mailing Address - Fax:301-565-0916
Practice Address - Street 1:1400 SPRING ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-2735
Practice Address - Country:US
Practice Address - Phone:301-565-0914
Practice Address - Fax:301-565-0916
Is Sole Proprietor?:No
Enumeration Date:2012-08-17
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1024731363LF0000X
MDR154872363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily