Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | RN280593 | MA |
NPI | 1033431739 |
---|---|
Provider Name | Meghan Cobb |
First Address | Dorchester Center, MA 02124-2737 |
Second Address | Dorchester Center, MA 02124-2737 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/02/2010 |
Last Update Date | 21/07/2014 |