Healthcare Provider Details

I. General information

NPI: 1003688029
Provider Name (Legal Business Name): DAYNA LEE COHEN RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2023
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9685 PHOENICIAN AVE
LAS VEGAS NV
89147-8343
US

IV. Provider business mailing address

9685 PHOENICIAN AVE
LAS VEGAS NV
89147-8343
US

V. Phone/Fax

Practice location:
  • Phone: 403-601-1601
  • Fax:
Mailing address:
  • Phone: 702-468-3579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number40277-DI-0
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: