Provider Demographics
NPI:1043332042
Name:KOHANSKI, PAUL (MSN CNP)
Entity Type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:KOHANSKI
Suffix:
Gender:M
Credentials:MSN CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24701 EUCLID AVE
Mailing Address - Street 2:3RD FLOOR
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44117-1714
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11100 EUCLID AVE
Practice Address - Street 2:MP3500 MS 5078
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-1716
Practice Address - Country:US
Practice Address - Phone:216-844-1402
Practice Address - Fax:216-844-7492
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA09374-NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2943953Medicaid
OHCOA09374-NPOtherCERTIFICATE OF AUTHORITY
OHCOA09374-NPOtherCERTIFICATE OF AUTHORITY
OHKONP30611Medicare PIN