Provider Demographics
NPI:1942546098
Name:KOBRAVI, AMELIA ARTHUR (PA-C)
Entity type:Individual
Prefix:
First Name:AMELIA
Middle Name:ARTHUR
Last Name:KOBRAVI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4909 GREEN RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27616-3418
Mailing Address - Country:US
Mailing Address - Phone:919-790-0288
Mailing Address - Fax:
Practice Address - Street 1:4909 GREEN RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27616-3418
Practice Address - Country:US
Practice Address - Phone:919-790-0288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-18
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-03967363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant