Provider Demographics
NPI:1427797133
Name:COBARRUBIAS, KATHERINE (ATC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:
Last Name:COBARRUBIAS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5731 FOUNTAIN GROVE CIR APT 278
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28304-2671
Mailing Address - Country:US
Mailing Address - Phone:909-319-8365
Mailing Address - Fax:
Practice Address - Street 1:HHC 1ST BRIGADE
Practice Address - Street 2:5812 ARDENNES ST
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28307
Practice Address - Country:US
Practice Address - Phone:910-432-5902
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-01
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000050697OtherBOARD OF CERTIFICATION FOR ATHLETIC TRAINING