Provider Demographics
NPI:1982832671
Name:COHAN, DEBORAH FAITH (CNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:FAITH
Last Name:COHAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:DEBORAH
Other - Middle Name:FAITH
Other - Last Name:KATCHER-BUCKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:35 PEARL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BROCKTON
Mailing Address - State:MA
Mailing Address - Zip Code:02301-2866
Mailing Address - Country:US
Mailing Address - Phone:508-588-8034
Mailing Address - Fax:508-897-0475
Practice Address - Street 1:35 PEARL ST STE 200
Practice Address - Street 2:
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-2866
Practice Address - Country:US
Practice Address - Phone:508-588-8034
Practice Address - Fax:508-897-0475
Is Sole Proprietor?:No
Enumeration Date:2009-07-01
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN284422363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1982832671Medicare Oscar/Certification