Provider Demographics
NPI:1114238078
Name:COHEN TRUDEL, ELISHEVA C (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:ELISHEVA
Middle Name:C
Last Name:COHEN TRUDEL
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:M
Other - Last Name:TRUDEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 WALL ST STE 300
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101-1518
Mailing Address - Country:US
Mailing Address - Phone:603-668-4111
Mailing Address - Fax:603-628-7757
Practice Address - Street 1:2 WALL ST STE 300
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101-1518
Practice Address - Country:US
Practice Address - Phone:603-668-4111
Practice Address - Fax:603-628-7757
Is Sole Proprietor?:No
Enumeration Date:2010-06-25
Last Update Date:2022-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH059420-21163WP0808X
NH059420-23363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health