Healthcare Provider Details

I. General information

NPI: 1811817497
Provider Name (Legal Business Name): VANESSA R COBB PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1771 E FLAMINGO RD STE 112B
LAS VEGAS NV
89119-0851
US

IV. Provider business mailing address

1771 E FLAMINGO RD STE 112B
LAS VEGAS NV
89119-0851
US

V. Phone/Fax

Practice location:
  • Phone: 702-425-8757
  • Fax:
Mailing address:
  • Phone: 702-425-8757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number831597
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: