Provider Demographics
NPI:1649986936
Name:KOBLE, KATHRYN KEYES (NP)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:KEYES
Last Name:KOBLE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 ARBUTUS TRL
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-1408
Mailing Address - Country:US
Mailing Address - Phone:937-478-7016
Mailing Address - Fax:
Practice Address - Street 1:2 ARBUTUS TRL
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-1408
Practice Address - Country:US
Practice Address - Phone:937-478-7016
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC245499163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC245499OtherRN NUMBER