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Organization
NURSE PRACTIONER
Active
Organization
NURSE PRACTIONER
Active
Parent organization
INDEPENDENT CONTRACTOR
Organization subpart
Yes
Provider details
NPI number
Legal business name
INDEPENDENT CONTRACTOR
Authorized official
ROSE KOMBE NP (FNP)
(404) 579-1658
Entity
Organization
Contact information
Practice address
4044 GEORGE BUSBEE PKWY NW APT 4207, KENNESAW, GA 30144-6890
(404) 579-1658
Mailing address
PO BOX 1234, POWDER SPRINGS, GA 30127-7234
(404) 579-1658
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
193760
GA
305S00000X
Point of Service
193760
GA
Other
Enumeration date
03/15/2017
Last updated
03/15/2017
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