Provider Demographics
NPI:1891377990
Name:COHEN, MEGAN JACE (APRN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:JACE
Last Name:COHEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5295 S TRIMBLE RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-2174
Mailing Address - Country:US
Mailing Address - Phone:404-695-7993
Mailing Address - Fax:
Practice Address - Street 1:714 PRESIDENT PL # 250
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5651
Practice Address - Country:US
Practice Address - Phone:615-223-9876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN30334363L00000X
TN12282562163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse