Provider Demographics
NPI:1588252373
Name:KOHN, FELICIA SUZANNE (RN)
Entity type:Individual
Prefix:
First Name:FELICIA
Middle Name:SUZANNE
Last Name:KOHN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 MINDY AVE
Mailing Address - Street 2:
Mailing Address - City:MERRITT ISLAND
Mailing Address - State:FL
Mailing Address - Zip Code:32953-4439
Mailing Address - Country:US
Mailing Address - Phone:914-424-5058
Mailing Address - Fax:
Practice Address - Street 1:230 MINDY AVE
Practice Address - Street 2:
Practice Address - City:MERRITT ISLAND
Practice Address - State:FL
Practice Address - Zip Code:32953-4439
Practice Address - Country:US
Practice Address - Phone:914-424-5058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-06
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9365370163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse