Provider Demographics
NPI:1700645140
Name:ISAACS-COCHRAN, MCKINLEY BROOKE (PMHNP)
Entity type:Individual
Prefix:MS
First Name:MCKINLEY
Middle Name:BROOKE
Last Name:ISAACS-COCHRAN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WISE
Mailing Address - State:VA
Mailing Address - Zip Code:24293-5402
Mailing Address - Country:US
Mailing Address - Phone:276-298-5034
Mailing Address - Fax:276-213-3014
Practice Address - Street 1:217 E MAIN ST
Practice Address - Street 2:
Practice Address - City:WISE
Practice Address - State:VA
Practice Address - Zip Code:24293-5402
Practice Address - Country:US
Practice Address - Phone:276-298-5034
Practice Address - Fax:276-213-3014
Is Sole Proprietor?:No
Enumeration Date:2024-03-18
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN257386163W00000X
VA0024190424363LP0808X
TN36088363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse