Provider Demographics
NPI:1932947793
Name:KOHAN, MAURA (MSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:MAURA
Middle Name:
Last Name:KOHAN
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MOUNT AUBURN ST
Mailing Address - Street 2:PARSONS 2
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-2463
Mailing Address - Country:US
Mailing Address - Phone:978-799-3670
Mailing Address - Fax:
Practice Address - Street 1:480 PLEASANT ST # 300A
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-2463
Practice Address - Country:US
Practice Address - Phone:617-926-9000
Practice Address - Fax:617-926-7053
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAAPRN10002358363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner