Healthcare Provider Details

I. General information

NPI: 1518518323
Provider Name (Legal Business Name): JASMINE BARKSDALE COBB NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/23/2019
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BIDDLE AVE STE 101
NEWARK DE
19702-3982
US

IV. Provider business mailing address

100 BIDDLE AVE STE 101
NEWARK DE
19702-3982
US

V. Phone/Fax

Practice location:
  • Phone: 302-392-6501
  • Fax:
Mailing address:
  • Phone: 302-392-6501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP021043
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0001329
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: