Provider Demographics
NPI:1447965736
Name:COBB, ALYSSA L (AGNP)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:L
Last Name:COBB
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DUKE MEDICINE CIR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27710-2000
Mailing Address - Country:US
Mailing Address - Phone:919-660-2160
Mailing Address - Fax:919-668-7345
Practice Address - Street 1:20 DUKE MEDICINE CIR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-2000
Practice Address - Country:US
Practice Address - Phone:919-660-2160
Practice Address - Fax:919-668-7345
Is Sole Proprietor?:No
Enumeration Date:2023-01-20
Last Update Date:2023-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5017525363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner