Provider Demographics
NPI:1114736691
Name:COCHRAN, JODY LYNN (CRNP)
Entity type:Individual
Prefix:
First Name:JODY
Middle Name:LYNN
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10260 SILVERSIDE ST STE 100
Mailing Address - Street 2:
Mailing Address - City:IJAMSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21754-9174
Mailing Address - Country:US
Mailing Address - Phone:240-344-0793
Mailing Address - Fax:
Practice Address - Street 1:10260 SILVERSIDE ST STE 200
Practice Address - Street 2:
Practice Address - City:IJAMSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21754-9174
Practice Address - Country:US
Practice Address - Phone:301-682-4100
Practice Address - Fax:240-744-1540
Is Sole Proprietor?:No
Enumeration Date:2024-12-30
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR215335363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily