Jacque Cobb, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10063313 Issued in OR

Practice address

2801 St Anthony Way
Pendleton, OR 97801-3800

Phone

(541) 276-5121

Fax

(541) 278-4579

NPI assigned

Oct 24, 2023

Reactivated

Jul 16, 2026

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1698105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1093587933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 ST ANTHONY WAY",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013800",
            "telephone_number": "541-276-5121",
            "fax_number": "541-278-4579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 ST ANTHONY WAY",
            "city": "PENDLETON",
            "state": "OR",
            "postal_code": "978013800",
            "telephone_number": "541-276-5121",
            "fax_number": "541-278-4579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "JACQUE",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-10-24",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "deactivation_date": "2026-04-30",
        "reactivation_date": "2026-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OR",
            "license": "200340354",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OR",
            "license": "10063313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katie A Clark
• Robert Marc Clark, LCSW LICENSED CLINIC
• Timothy John Clark
• Clearview Disability Resource Center
• Mark Steven Clippinger, MD
• Rena I Cochran, CNA
• Shelia Helene Coe
• Lindsey M Coiner, RN
• Elizabeth Coleman, INTERN, QMHP
• Madeleine Coleman, PHARMD, RPH

• Family Nurse Practitioner in Pendleton, OR
• Providers in Pendleton, OR by specialty
• Family Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.