Basic Information
Provider Information
NPI: 1497264170
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COBBS MIN
FirstName: ROBIN
MiddleName: GAYLE
NamePrefix:  
NameSuffix:  
Credential: APRN FNP-BC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: CHUKES
OtherFirstName: ROBIN
OtherMiddleName: GAYLE
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: APRN FNP-BC
OtherLastNameType: 1
Mailing Information
Address1: 2845 BELL ST
Address2:  
City: ZANESVILLE
State: OH
PostalCode: 437011720
CountryCode: US
TelephoneNumber: 7404549766
FaxNumber: 7405886452
Practice Location
Address1: 2845 BELL ST
Address2:  
City: ZANESVILLE
State: OH
PostalCode: 437011720
CountryCode: US
TelephoneNumber: 7404549766
FaxNumber: 7405886452
Other Information
ProviderEnumerationDate: 09/25/2017
LastUpdateDate: 08/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 08/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X5441MNN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LF0000XAPRN.CNP.0028747OHY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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