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Individual

MARY ELIZABETH COMBS

Active
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Individual

MARY ELIZABETH COMBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

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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