Individual
MISS AMBER KAYLA COCHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
527 MEDICAL PARK DR STE 400, BRIDGEPORT, WV 26330-9010
(681) 342-3550
(681) 342-3507
Mailing address
527 MEDICAL PARK DR STE 400, BRIDGEPORT, WV 26330-9010
(681) 342-3550
(681) 342-3507
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
64486
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3810008621
MEDICAID
WV
01
—
WV2678A
MEDICARE PTAN
WV
Enumeration date
08/10/2009
Last updated
05/28/2014
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