Provider Demographics
NPI:1013439082
Name:COBLE, REBECCA (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:COBLE
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4196 HIGHWAY 62 412 STE A
Mailing Address - Street 2:
Mailing Address - City:HARDY
Mailing Address - State:AR
Mailing Address - Zip Code:72542-8002
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:870-994-7488
Practice Address - Street 1:3519 HIGHWAY 63
Practice Address - Street 2:
Practice Address - City:BLACK ROCK
Practice Address - State:AR
Practice Address - Zip Code:72415-9022
Practice Address - Country:US
Practice Address - Phone:870-878-4005
Practice Address - Fax:870-994-7488
Is Sole Proprietor?:No
Enumeration Date:2017-07-12
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005216363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily