Provider Demographics
NPI:1699878926
Name:MCCOMBS, PATRICIA ANNE (RD, LDN)
Entity type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:ANNE
Last Name:MCCOMBS
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:MS
Other - First Name:PATRICIA
Other - Middle Name:ANNE
Other - Last Name:MCCOMBS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:617 SOUTH HWY 343
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:NC
Mailing Address - Zip Code:27921
Mailing Address - Country:US
Mailing Address - Phone:252-337-6791
Mailing Address - Fax:252-337-6792
Practice Address - Street 1:711 ROANOKE AVE
Practice Address - Street 2:ALBEMARLE REGIONAL HEALTH SERVICES
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909
Practice Address - Country:US
Practice Address - Phone:252-338-4370
Practice Address - Fax:252-337-7911
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2009-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL 001484133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCL 001484OtherLICENSURE