Provider Demographics
NPI:1053182279
Name:COBB, DIANA MARIE (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:MARIE
Last Name:COBB
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 1:2402 HIGHWAY 221 S
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-7618
Mailing Address - Country:US
Mailing Address - Phone:864-993-2524
Mailing Address - Fax:
Practice Address - Street 1:2402 HIGHWAY 221 S
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-7618
Practice Address - Country:US
Practice Address - Phone:864-993-2524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC79108163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse