MEDICARE: CAROLINE 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
1	363L00000X	Nurse Practitioner	AP60513538	WA
2	363LP2300X	Primary Care Nurse Practitioner	AP60513538	WA
3	363LF0000X	Family Nurse Practitioner	AP60513538	WA

General Provider Information

NPI Number	:	1851796668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAROLINE COBB ARNP

Provider Business Mailing Address
First Line	:	111 UNIVERSITY PKWY STE 104
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98901-1448
Country	:	US
Telephone Number	:	509-767-6447
Fax Number	:	509-225-9415

Provider Business Practice Location Address
First Line	:	111 UNIVERSITY PKWY STE 104
Second Line	:
City	:	YAKIMA
State	:	WA
Zip	:	98901-1448
Country	:	US
Telephone Number	:	509-767-6447
Fax Number	:	509-225-9415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2014
Last Update Date	:	04/10/2025

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