Provider Demographics
NPI:1063972701
Name:COBRAND, BILLYJEAN ANN
Entity type:Individual
Prefix:
First Name:BILLYJEAN
Middle Name:ANN
Last Name:COBRAND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 ARCADIA AVE
Mailing Address - Street 2:
Mailing Address - City:CAPITOL HEIGHTS
Mailing Address - State:MD
Mailing Address - Zip Code:20743-5702
Mailing Address - Country:US
Mailing Address - Phone:443-682-4617
Mailing Address - Fax:
Practice Address - Street 1:1715 ARCADIA AVE
Practice Address - Street 2:
Practice Address - City:CAPITOL HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20743-5702
Practice Address - Country:US
Practice Address - Phone:443-682-4617
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2019-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide