Healthcare Provider Details

I. General information

NPI: 1508791260
Provider Name (Legal Business Name): DR. MARY JANET COHORST
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 MARY ST
EVANSVILLE IN
47710-1658
US

IV. Provider business mailing address

850 BLUE RIDGE RD
EVANSVILLE IN
47714-0630
US

V. Phone/Fax

Practice location:
  • Phone: 812-450-3394
  • Fax:
Mailing address:
  • Phone: 618-518-0250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835C0205X
TaxonomyCritical Care Pharmacist
License Number26024464A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: