Provider Demographics
NPI:1518739432
Name:BERENBERG, COHAN MCCALL (RN)
Entity Type:Individual
Prefix:
First Name:COHAN
Middle Name:MCCALL
Last Name:BERENBERG
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1888 RAINEYS BLVD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73025-2022
Mailing Address - Country:US
Mailing Address - Phone:405-513-2381
Mailing Address - Fax:
Practice Address - Street 1:1888 RAINEYS BLVD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73025-2022
Practice Address - Country:US
Practice Address - Phone:405-513-2381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKR0136776163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse