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Individual

DONNA G COBB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
50 PARKWAY LN STE B, PETAL, MS 39465-3035
(601) 705-2897
(601) 584-6457
Mailing address
415 S 28TH AVE, HATTIESBURG, MS 39401-7246
(601) 795-0659
(601) 579-5240

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R592153
MS
363LF0000X
Family Nurse Practitioner
Primary
R592153
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00118666
MS
05
1791211
LA
01
640507572KY
AMERICAN ADMIN GROUP
MS
Enumeration date
08/01/2006
Last updated
07/20/2020
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