Provider Demographics
NPI:1508442070
Name:COHN, LIA CHASE (RN)
Entity Type:Individual
Prefix:MRS
First Name:LIA
Middle Name:CHASE
Last Name:COHN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LIA
Other - Middle Name:CHASE
Other - Last Name:DUNSTAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:5405 HAYES DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2253
Mailing Address - Country:US
Mailing Address - Phone:505-331-0181
Mailing Address - Fax:
Practice Address - Street 1:516 E NIZHONI BLVD
Practice Address - Street 2:
Practice Address - City:GALLUP
Practice Address - State:NM
Practice Address - Zip Code:87301-5748
Practice Address - Country:US
Practice Address - Phone:505-722-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-23
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-84677163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency