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NPI Code Detail

MEDICARE: AMANDA COBB RN

MEDICARE:   AMANDA  COBB  RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC1500XCommunity Health Registered Nurse75905SC

General Provider Information

NPI Number : 1821417312
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA COBB RN
Provider Business Mailing Address
First Line : 604 SHADED ACRE CT
Second Line :
City : PELZER
State : SC
Zip : 29669-8956
Country : US
Telephone Number : 864-372-3195
Fax Number :
Provider Business Practice Location Address
First Line : 300 UNIVERSITY RDG
Second Line :
City : GREENVILLE
State : SC
Zip : 29601-4712
Country : US
Telephone Number : 864-372-3195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2014
Last Update Date : 04/10/2014

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Directions to “ AMANDA COBB RN” Practice Location

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