Provider Demographics
NPI:1518508761
Name:COSBY, CHELAUNA NICOLE
Entity Type:Individual
Prefix:MRS
First Name:CHELAUNA
Middle Name:NICOLE
Last Name:COSBY
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 1:3302 ROBINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-5221
Mailing Address - Country:US
Mailing Address - Phone:423-454-9493
Mailing Address - Fax:
Practice Address - Street 1:3302 ROBINWOOD DR
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128-5221
Practice Address - Country:US
Practice Address - Phone:423-454-9493
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-30
Last Update Date:2019-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator