Provider Demographics
NPI:1124495221
Name:COBB, NANCY (PA-C)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:COBB
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8966 W BOWLES AVE STE L
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80123-3454
Mailing Address - Country:US
Mailing Address - Phone:303-972-2727
Mailing Address - Fax:303-972-8652
Practice Address - Street 1:8966 W BOWLES AVE STE L
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-3454
Practice Address - Country:US
Practice Address - Phone:303-972-2727
Practice Address - Fax:303-972-8652
Is Sole Proprietor?:No
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO456363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant