Provider Demographics
NPI:1962277814
Name:KOBRIGER, TERI SUE (RN BSN)
Entity type:Individual
Prefix:
First Name:TERI
Middle Name:SUE
Last Name:KOBRIGER
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 KINGS LINKS ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-6107
Mailing Address - Country:US
Mailing Address - Phone:509-209-7387
Mailing Address - Fax:
Practice Address - Street 1:2298 W HORIZON RIDGE PKWY STE 100
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2697
Practice Address - Country:US
Practice Address - Phone:702-869-4401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVRN78810163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse