Provider Demographics
NPI:1982474342
Name:COHEN, KRISTEN LEANNE
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LEANNE
Last Name:COHEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:LEANNE
Other - Last Name:SHERLOTTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:39 ANNAPOLIS DR
Mailing Address - Street 2:
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-2301
Mailing Address - Country:US
Mailing Address - Phone:732-768-6944
Mailing Address - Fax:
Practice Address - Street 1:999 PALMER AVE
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-1087
Practice Address - Country:US
Practice Address - Phone:732-671-3313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14867300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily