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NPI Code Detail

MEDICARE: MS. SUSANNA ROSE COHEN RN, CNM, NP, MS, PHN

MEDICARE: MS. SUSANNA ROSE COHEN RN, CNM, NP, MS, PHN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC1500XCommunity Health Registered Nurse68184CA
2163W00000XRegistered Nurse640515CA
3363LW0102XWomen's Health Nurse Practitioner16782CA
4367A00000XAdvanced Practice Midwife1236NY
5367A00000XAdvanced Practice Midwife1730CA
6367A00000XAdvanced Practice Midwife6796151-4402UT

General Provider Information

NPI Number : 1033391552
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSANNA ROSE COHEN RN, CNM, NP, MS, PHN
Provider Business Mailing Address
First Line : 10 S 2000 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84112-5880
Country : US
Telephone Number : 801-581-8244
Fax Number :
Provider Business Practice Location Address
First Line : 10 S 2000 E
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84112-5880
Country : US
Telephone Number : 801-581-8244
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2007
Last Update Date : 11/12/2021

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