Provider Demographics
NPI:1568889095
Name:COHEN, JULIE (CRNP)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:
Other - Last Name:COHEN SANCLEMENTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:333 W UNION ST
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18102-5401
Mailing Address - Country:US
Mailing Address - Phone:610-820-7605
Mailing Address - Fax:
Practice Address - Street 1:1101 NORTHAMPTON ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-4152
Practice Address - Country:US
Practice Address - Phone:484-544-3113
Practice Address - Fax:610-841-8457
Is Sole Proprietor?:No
Enumeration Date:2014-03-21
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP016742363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASP016742Medicaid