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NPI Code Detail

MEDICARE: AMY BECKMAN COBB ARNP

MEDICARE: AMY BECKMAN COBB ARNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner4333PKY
2363LF0000XFamily Nurse PractitionerRN193814GA

General Provider Information

NPI Number : 1508838830
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMY BECKMAN COBB ARNP
Provider Business Mailing Address
First Line : 50 S B B KING BLVD
Second Line :
City : MEMPHIS
State : TN
Zip : 38103-2626
Country : US
Telephone Number : 866-949-0108
Fax Number :
Provider Business Practice Location Address
First Line : 303 SMITH ST
Second Line :
City : LAGRANGE
State : GA
Zip : 30240-2745
Country : US
Telephone Number : 706-812-4391
Fax Number : 706-812-4032
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2006
Last Update Date : 04/18/2022

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