Healthcare Provider Details

I. General information

NPI: 1619180122
Provider Name (Legal Business Name): LINDA SUSAN COHEN CNM, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 01/22/2021
Certification Date: 01/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1701 W 72ND AVE
DENVER CO
80221-2721
US

IV. Provider business mailing address

719 SAN MATEO BLVD NE
ALBUQUERQUE NM
87108-1434
US

V. Phone/Fax

Practice location:
  • Phone: 303-650-4460
  • Fax:
Mailing address:
  • Phone: 505-485-0464
  • Fax: 505-266-1017

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number757
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number811910
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAPN.0003064-CNM
License Number StateCO
# 4
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number109680
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: