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General NPI Number Information
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NPI Number | 1730526864
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Entity Type | Individual
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Provider Name | RICKEY ALLEN COSBY APRN
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Gender | Male
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Dates
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Enumeration Date | 05/30/2013
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 3939 7TH STREET RD
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City | LOUISVILLE
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State | KY
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Zip | 40216-4103
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Country | US
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Telephone | 502-883-6800
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Fax | 502-384-2316
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Provider Business Mailing Address
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Address Line | 3939 7TH STREET RD
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City | LOUISVILLE
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State | KY
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Zip | 40216-4103
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Country | US
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Telephone | 502-883-6800
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Fax | 502-384-2316
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 17677
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 17677
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | CTP.19109
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3009651
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License Number State | KY
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