Provider Demographics
NPI:1740004464
Name:KOHL, KIERSTEN SAMANTHA
Entity type:Individual
Prefix:
First Name:KIERSTEN
Middle Name:SAMANTHA
Last Name:KOHL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:COSHOCTON
Mailing Address - State:OH
Mailing Address - Zip Code:43812-1705
Mailing Address - Country:US
Mailing Address - Phone:740-294-0910
Mailing Address - Fax:
Practice Address - Street 1:175 1/2 PARK AVE
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812-1631
Practice Address - Country:US
Practice Address - Phone:740-575-1719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-09
Last Update Date:2024-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant