Provider Demographics
NPI:1962717132
Name:COMBS, JANIE (ARNP)
Entity type:Individual
Prefix:
First Name:JANIE
Middle Name:
Last Name:COMBS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 DANIEL BOONE PLZ
Mailing Address - Street 2:
Mailing Address - City:HAZARD
Mailing Address - State:KY
Mailing Address - Zip Code:41701-5334
Mailing Address - Country:US
Mailing Address - Phone:606-487-9999
Mailing Address - Fax:606-487-9179
Practice Address - Street 1:48 DANIEL BOONE PLZ
Practice Address - Street 2:
Practice Address - City:HAZARD
Practice Address - State:KY
Practice Address - Zip Code:41701-5334
Practice Address - Country:US
Practice Address - Phone:606-487-9999
Practice Address - Fax:606-487-9179
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-12
Last Update Date:2013-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6522P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner