Provider Demographics
NPI:1740801190
Name:COBB, AMBER LOUISE (NP)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:LOUISE
Last Name:COBB
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:418 W STEEL ST
Mailing Address - Street 2:
Mailing Address - City:SEYMOUR
Mailing Address - State:MO
Mailing Address - Zip Code:65746-8832
Mailing Address - Country:US
Mailing Address - Phone:417-935-2239
Mailing Address - Fax:
Practice Address - Street 1:418 W STEEL ST
Practice Address - Street 2:
Practice Address - City:SEYMOUR
Practice Address - State:MO
Practice Address - Zip Code:65746-8832
Practice Address - Country:US
Practice Address - Phone:417-935-2239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-27
Last Update Date:2022-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013034321363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily