Provider Demographics
NPI:1609264969
Name:COBY, CHANTELL DAWN (MSN, RN, PMHNP)
Entity Type:Individual
Prefix:
First Name:CHANTELL
Middle Name:DAWN
Last Name:COBY
Suffix:
Gender:F
Credentials:MSN, RN, PMHNP
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:206 JACKSON ST
Mailing Address - Street 2:
Mailing Address - City:MOOREFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26836-1287
Mailing Address - Country:US
Mailing Address - Phone:304-530-5980
Mailing Address - Fax:
Practice Address - Street 1:206 JACKSON ST
Practice Address - Street 2:
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26836-1287
Practice Address - Country:US
Practice Address - Phone:304-530-5980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-08
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDMC5162728363LP0808X
WVAPRN52981NP363LP0808X
MDN97199363LP0808X
WVMC3485706363LP0808X
WVRXA2699363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health