Healthcare Provider Details

I. General information

NPI: 1568166007
Provider Name (Legal Business Name): ANA ABIGAIL COBB BS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABBY COBB BS

II. Dates (important events)

Enumeration Date: 03/29/2023
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 ARCH ST
AKRON OH
44304-1429
US

IV. Provider business mailing address

1105 MASSEY WAY
AKRON OH
44312-5261
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-6262
  • Fax:
Mailing address:
  • Phone: 606-416-9010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number11206
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: