Individual
JUANITA M COMBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
800 W MAIN ST, COLDWATER, OH 45828
(419) 678-2341
Mailing address
60 N STATE ROUTE 101 LOT 63, TIFFIN, OH 44883-8449
(333) 098-0529
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN192146
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000540662
ANTHEM
OH
05
—
2794114
—
OH
01
—
8240961
MEDICARE PTAN
OH
01
—
P00462364
MEDICARE RAILROAD
OH
Enumeration date
11/09/2007
Last updated
07/19/2019
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