Basic Information
Provider Information
NPI: 1669087151
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COCHRAN
FirstName: RACHEL
MiddleName: MAY
NamePrefix:  
NameSuffix:  
Credential: CNM
OtherOrganizationName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2925 CHICAGO AVE
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554071321
CountryCode: US
TelephoneNumber: 6122625000
FaxNumber:  
Practice Location
Address1: 347 SMITH AVE N
Address2:  
City: SAINT PAUL
State: MN
PostalCode: 551022387
CountryCode: US
TelephoneNumber: 6512417733
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/10/2020
LastUpdateDate: 12/02/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/02/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367A00000X2302023MNY Physician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife 

No ID Information.


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