Provider Demographics
NPI:1427785831
Name:COBB, KRISTINA L (RN)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:L
Last Name:COBB
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KRIS
Other - Middle Name:
Other - Last Name:WARTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1460 GREYSON LN
Mailing Address - Street 2:
Mailing Address - City:NORTH LIBERTY
Mailing Address - State:IA
Mailing Address - Zip Code:52317-8101
Mailing Address - Country:US
Mailing Address - Phone:319-850-0182
Mailing Address - Fax:
Practice Address - Street 1:1460 GREYSON LN
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-8101
Practice Address - Country:US
Practice Address - Phone:319-850-0182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-04
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA131290163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse