Healthcare Provider Details

I. General information

NPI: 1851220388
Provider Name (Legal Business Name): CORINNA CHULADA COHN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 MEMORIAL DR
PINEHURST NC
28374-8710
US

IV. Provider business mailing address

141 AMELIA DR
CARTHAGE NC
28327-0050
US

V. Phone/Fax

Practice location:
  • Phone: 910-715-1000
  • Fax:
Mailing address:
  • Phone: 978-944-2319
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number334119
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: