Provider Demographics
NPI:1316926348
Name:COBB, KELLY LYNN (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:LYNN
Last Name:COBB
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3876 NC HIGHWAY 86 S
Mailing Address - Street 2:
Mailing Address - City:YANCEYVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27379-9426
Mailing Address - Country:US
Mailing Address - Phone:336-694-6223
Mailing Address - Fax:
Practice Address - Street 1:189 COUNTY PARK RD
Practice Address - Street 2:
Practice Address - City:YANCEYVILLE
Practice Address - State:NC
Practice Address - Zip Code:27379-9376
Practice Address - Country:US
Practice Address - Phone:336-694-4129
Practice Address - Fax:336-694-7030
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2021-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC201882363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily