Provider Demographics
NPI:1548632003
Name:COHEN, BETH ANN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:BETH
Middle Name:ANN
Last Name:COHEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:365 LENNON LN
Mailing Address - Street 2:STE 250
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-5915
Mailing Address - Country:US
Mailing Address - Phone:925-948-8143
Mailing Address - Fax:925-948-8143
Practice Address - Street 1:2040 ROSEBUD DR STE 7
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-6294
Practice Address - Country:US
Practice Address - Phone:406-969-4812
Practice Address - Fax:406-969-4814
Is Sole Proprietor?:No
Enumeration Date:2015-10-23
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MTMED-PAC-LIC 287363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical