Provider Demographics
NPI:1861077448
Name:COBB, MEGAN ANN
Entity type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:COBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2455 QUEENSWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219-1376
Mailing Address - Country:US
Mailing Address - Phone:614-779-5431
Mailing Address - Fax:
Practice Address - Street 1:2455 QUEENSWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219-1376
Practice Address - Country:US
Practice Address - Phone:614-779-5431
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-15
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker