Healthcare Provider Details

I. General information

NPI: 1770892689
Provider Name (Legal Business Name): ALISSA ANNE COHOAT NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2010
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8501 E 56TH ST STE 110
INDIANAPOLIS IN
46216-2118
US

IV. Provider business mailing address

8501 E 56TH ST STE 110
INDIANAPOLIS IN
46216-2118
US

V. Phone/Fax

Practice location:
  • Phone: 317-621-1207
  • Fax:
Mailing address:
  • Phone: 317-621-1207
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WW0101X
TaxonomyAmbulatory Women's Health Care Registered Nurse
License Number28161577A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71003449A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: