Provider Demographics
NPI:1932482346
Name:COBB, ANNETTE B (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANNETTE
Middle Name:B
Last Name:COBB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:408 RAMBLER RD
Mailing Address - Street 2:
Mailing Address - City:ELMIRA
Mailing Address - State:NY
Mailing Address - Zip Code:14905-2147
Mailing Address - Country:US
Mailing Address - Phone:607-733-8800
Mailing Address - Fax:
Practice Address - Street 1:812 CENTER ST
Practice Address - Street 2:
Practice Address - City:HORSEHEADS
Practice Address - State:NY
Practice Address - Zip Code:14845-2320
Practice Address - Country:US
Practice Address - Phone:607-795-2580
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3884301163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse