Kirby Monique Cobb
Individual provider Active NPI Prosthetist · Pearl, MS
NPI 1972196269 · NPPES record last updated Feb 17, 2021
Key facts
- NPI
- 1972196269
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prosthetist 224P00000X
- License
- 01-10259 (MS)
- Practice address
- 2709 Old Brandon Rd
Pearl, MS 39208-4702 - Phone
- (769) 208-6109
- NPI assigned
- Feb 17, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01-10259 | MS | MD | Prosthetist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetist | 224P00000X | 01-10259 | MS | Yes |
Addresses
Primary practice location
2709 Old Brandon Rd
Pearl, MS 39208-4702
Mailing address
408 Poplar Blvd
Pearl, MS 39208
Phone (769) 798-9400
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | foryourglorybeauty@gmail.com | Health Information Exchange (HIE) |
Other providers in Pearl, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 17, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.