Individual
JACLYN R COCHRANE
Active
Individual
JACLYN R COCHRANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5601005220
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881695484
CLINI'S NPI
MI
01
—
5601005220
STATE LICENSE
MI
Enumeration date
09/15/2008
Last updated
12/17/2008
Update your record
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