Individual
MARY ELIZABETH COMBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
535 BARNHILL DR, INDIANAPOLIS, IN 46202-5116
(317) 944-0792
(317) 948-5949
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
28197944A
IN
363LA2100X
Acute Care Nurse Practitioner
Primary
71014875A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104122275
ANTHEM PTAN
IN
05
—
300087814
—
IN
Enumeration date
01/03/2024
Last updated
10/07/2024
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