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General NPI Number Information
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NPI Number | 1487791513
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Entity Type | Individual
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Provider Name | HOLLY ANNETTE COBLE HHA
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Gender | Female
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Dates
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Enumeration Date | 01/30/2007
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Last Update Date | 11/09/2023
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Provider Practice Location Address
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Address Line | 613 LUDWIG AVE
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City | GIBSONBURG
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State | OH
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Zip | 43431-1212
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Country | US
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Telephone | 419-307-5919
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Fax |
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Provider Business Mailing Address
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Address Line | 613 LUDWIG AVE
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City | GIBSONBURG
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State | OH
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Zip | 43431-1212
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Country | US
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Telephone | 419-307-5919
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 251E00000X
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License Number State | OH
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