Provider Demographics
NPI:1578776845
Name:COBB, CARRIE LA'SHA (LICENSED MIDWIFE)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LA'SHA
Last Name:COBB
Suffix:
Gender:F
Credentials:LICENSED MIDWIFE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5018 CLUB RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72207-4706
Mailing Address - Country:US
Mailing Address - Phone:501-663-9205
Mailing Address - Fax:
Practice Address - Street 1:5018 CLUB RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72207-4706
Practice Address - Country:US
Practice Address - Phone:501-663-9205
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR032006175M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay