Provider Demographics
NPI:1750979761
Name:COBIAN, ELIZABETH (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:COBIAN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:
Other - Last Name:COBIAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, APRN, FNP-C
Mailing Address - Street 1:3016 FORT CAROLINE CT
Mailing Address - Street 2:
Mailing Address - City:SAINT AUGUSTINE
Mailing Address - State:FL
Mailing Address - Zip Code:32092-2435
Mailing Address - Country:US
Mailing Address - Phone:321-947-9961
Mailing Address - Fax:
Practice Address - Street 1:100 WHETSTONE PL STE 206
Practice Address - Street 2:
Practice Address - City:ST AUGUSTINE
Practice Address - State:FL
Practice Address - Zip Code:32086-5775
Practice Address - Country:US
Practice Address - Phone:904-429-9892
Practice Address - Fax:904-217-7631
Is Sole Proprietor?:No
Enumeration Date:2021-01-05
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11010897363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner