Individual
LYDIA JANE COMBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5970 CHURCHVIEW DR, ROCKFORD, IL 61107-2574
(815) 971-2000
Mailing address
1917 KILBURN AVE, ROCKFORD, IL 61101-3457
(815) 871-2976
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
209013873
IL
364SF0001X
Family Health Clinical Nurse Specialist
209013873
IL
Other
Enumeration date
03/08/2016
Last updated
03/21/2016
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