Provider Demographics
NPI:1720535248
Name:COBB, CHELSEY ELIZABETH (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEY
Middle Name:ELIZABETH
Last Name:COBB
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CHELSEY
Other - Middle Name:ELIZABETH
Other - Last Name:BAUGHARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1049 MILLER ST
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-4457
Mailing Address - Country:US
Mailing Address - Phone:317-777-0697
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER BLVD.
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103
Practice Address - Country:US
Practice Address - Phone:336-713-5360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC113022367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered