Provider Demographics
NPI:1588351688
Name:COHN, JACQUELINE CARLY (WHNP, RN)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:CARLY
Last Name:COHN
Suffix:
Gender:F
Credentials:WHNP, RN
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Mailing Address - Street 1:13347 ORANGE BLOSSOM WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-2716
Mailing Address - Country:US
Mailing Address - Phone:847-306-0411
Mailing Address - Fax:
Practice Address - Street 1:11425 EL CAMINO REAL
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2045
Practice Address - Country:US
Practice Address - Phone:858-365-9605
Practice Address - Fax:619-848-7480
Is Sole Proprietor?:No
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA95004126363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health