Provider Demographics
NPI:1851435556
Name:COBB, JACQUELYN F (RN CDE)
Entity Type:Individual
Prefix:MS
First Name:JACQUELYN
Middle Name:F
Last Name:COBB
Suffix:
Gender:F
Credentials:RN CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20152 E BATAVIA DR
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80011-5424
Mailing Address - Country:US
Mailing Address - Phone:720-216-0030
Mailing Address - Fax:303-861-3605
Practice Address - Street 1:2500 S HAVANA ST
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-1618
Practice Address - Country:US
Practice Address - Phone:303-764-4739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO83259163WI0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WI0600XNursing Service ProvidersRegistered NurseInfection Control
Provider Identifiers
StateIdentifier IDID TypeIssuer
006616OtherKAISER-COMMERCIAL NUMBER