Provider Demographics
NPI:1679983084
Name:COHEN, JUDE ANNERYAN (RN, LSN)
Entity Type:Individual
Prefix:MRS
First Name:JUDE
Middle Name:ANNERYAN
Last Name:COHEN
Suffix:
Gender:F
Credentials:RN, LSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 FAR HILLS AVENUE
Mailing Address - Street 2:KETTERING CITY SCHOOLS,
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-2584
Mailing Address - Country:US
Mailing Address - Phone:937-499-1473
Mailing Address - Fax:937-499-1516
Practice Address - Street 1:1200 W. DOROTHY LANE,
Practice Address - Street 2:SOUTHDALE ELEMENTARY SCHOOL,
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45409
Practice Address - Country:US
Practice Address - Phone:937-499-1890
Practice Address - Fax:937-499-1909
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN208723163W00000X
OHMA100971163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool