Provider Demographics
NPI:1346582541
Name:COBBINS, AMY C (LPN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:C
Last Name:COBBINS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:C
Other - Last Name:BROOKOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13605 TERMINAL AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44135-1652
Mailing Address - Country:US
Mailing Address - Phone:216-671-6132
Mailing Address - Fax:
Practice Address - Street 1:13605 TERMINAL AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44135-1652
Practice Address - Country:US
Practice Address - Phone:216-671-6132
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-26
Last Update Date:2014-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 147275-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse