Provider Demographics
NPI:1356510150
Name:COBB, ELLA INETA (DPH)
Entity Type:Individual
Prefix:
First Name:ELLA
Middle Name:INETA
Last Name:COBB
Suffix:
Gender:F
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3209 ELAM FARMS PKWY
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37127-7787
Mailing Address - Country:US
Mailing Address - Phone:615-620-8411
Mailing Address - Fax:
Practice Address - Street 1:3209 ELAM FARMS PKWY
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37127-7787
Practice Address - Country:US
Practice Address - Phone:615-620-8411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN6223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist