Provider Demographics
NPI:1144051624
Name:COCHRAN, MARCY JO (RN)
Entity type:Individual
Prefix:MS
First Name:MARCY
Middle Name:JO
Last Name:COCHRAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:MARCY
Other - Middle Name:JO
Other - Last Name:KIDNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4697 HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:OH
Mailing Address - Zip Code:43906-1303
Mailing Address - Country:US
Mailing Address - Phone:740-968-7006
Mailing Address - Fax:
Practice Address - Street 1:4697 HARRISON ST
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:OH
Practice Address - Zip Code:43906-1303
Practice Address - Country:US
Practice Address - Phone:740-968-7006
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH392865163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult