MEDICARE: MS. MARCIA A. COHEN BS, RN, APN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN00472	NV

General Provider Information

NPI Number	:	1841403904
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARCIA A. COHEN BS, RN, APN

Provider Business Mailing Address
First Line	:	8430 W LAKE MEAD BLVD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7672
Country	:	US
Telephone Number	:	702-576-9870
Fax Number	:	702-576-9594

Provider Business Practice Location Address
First Line	:	8430 W LAKE MEAD BLVD
Second Line	:	SUITE 100
City	:	LAS VEGAS
State	:	NV
Zip	:	89128-7672
Country	:	US
Telephone Number	:	702-576-9870
Fax Number	:	702-576-9594

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/07/2007
Last Update Date	:	02/02/2017

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