Healthcare Provider Details

I. General information

NPI: 1922022912
Provider Name (Legal Business Name): SUSAN RITA COHEN F.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNC CAMPUS HEALTH SERVICES CAMPUS BOX # 7470
CHAPEL HILL NC
27599-7470
US

IV. Provider business mailing address

2028 PERSHING ST
DURHAM NC
27705-3220
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-6550
  • Fax: 919-966-0108
Mailing address:
  • Phone: 919-286-4650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number066015
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: