Provider Demographics
NPI:1851796668
Name:COBB, CAROLINE (ARNP)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:COBB
Suffix:
Gender:
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 UNIVERSITY PKWY STE 104
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98901-1448
Mailing Address - Country:US
Mailing Address - Phone:509-767-6447
Mailing Address - Fax:509-225-9415
Practice Address - Street 1:111 UNIVERSITY PKWY STE 104
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98901-1448
Practice Address - Country:US
Practice Address - Phone:509-767-6447
Practice Address - Fax:509-225-9415
Is Sole Proprietor?:No
Enumeration Date:2014-10-23
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60513538363L00000X, 363LP2300X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care