Provider Demographics
NPI:1982962015
Name:COBB, JULIANA M (RN)
Entity Type:Individual
Prefix:
First Name:JULIANA
Middle Name:M
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 1:516 ELM ST
Mailing Address - Street 2:NURSE'S OFFICE
Mailing Address - City:GROTON
Mailing Address - State:NY
Mailing Address - Zip Code:13073-1124
Mailing Address - Country:US
Mailing Address - Phone:607-898-5837
Mailing Address - Fax:607-898-5896
Practice Address - Street 1:516 ELM ST
Practice Address - Street 2:NURSE'S OFFICE
Practice Address - City:GROTON
Practice Address - State:NY
Practice Address - Zip Code:13073-1124
Practice Address - Country:US
Practice Address - Phone:607-898-5837
Practice Address - Fax:607-898-5896
Is Sole Proprietor?:No
Enumeration Date:2012-04-26
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY534841163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool