Provider Demographics
NPI:1366059107
Name:COMBE, MARCY LYNN
Entity type:Individual
Prefix:
First Name:MARCY
Middle Name:LYNN
Last Name:COMBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 792
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89432-0792
Mailing Address - Country:US
Mailing Address - Phone:775-276-4505
Mailing Address - Fax:
Practice Address - Street 1:11900 CHESAPEAKE DR
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89506-9495
Practice Address - Country:US
Practice Address - Phone:775-276-4505
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV999999999999999999993747A0650X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider