Provider Demographics
NPI:1619301926
Name:COBB, DEBORAH ELIZABETH (FNP)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:ELIZABETH
Last Name:COBB
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:924 N HOWE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28461-3038
Mailing Address - Country:US
Mailing Address - Phone:910-457-3800
Mailing Address - Fax:910-457-3842
Practice Address - Street 1:4700 E OAK ISLAND DR
Practice Address - Street 2:
Practice Address - City:OAK ISLAND
Practice Address - State:NC
Practice Address - Zip Code:28465-5257
Practice Address - Country:US
Practice Address - Phone:910-278-6414
Practice Address - Fax:855-763-1167
Is Sole Proprietor?:No
Enumeration Date:2013-08-23
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5006420363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCNCG354BMedicare PIN