Healthcare Provider Details

I. General information

NPI: 1275451866
Provider Name (Legal Business Name): KERRICK COBLE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

528 N WALNUT ST
MURFREESBORO TN
37130-2852
US

IV. Provider business mailing address

1101 DOWNS BLVD APT J105
FRANKLIN TN
37064-3867
US

V. Phone/Fax

Practice location:
  • Phone: 615-732-9149
  • Fax:
Mailing address:
  • Phone: 615-732-9149
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: