Provider Demographics
NPI:1083713168
Name:COMBS, BRYAN PATRICK (PHD, CRNP, FNP-S)
Entity Type:Individual
Prefix:
First Name:BRYAN
Middle Name:PATRICK
Last Name:COMBS
Suffix:
Gender:M
Credentials:PHD, CRNP, FNP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 OLDE ENGLISH LN STE 100
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN BRK
Mailing Address - State:AL
Mailing Address - Zip Code:35223-1062
Mailing Address - Country:US
Mailing Address - Phone:205-901-7932
Mailing Address - Fax:
Practice Address - Street 1:600 OLDE ENGLISH LN STE 100
Practice Address - Street 2:
Practice Address - City:MOUNTAIN BRK
Practice Address - State:AL
Practice Address - Zip Code:35223-1062
Practice Address - Country:US
Practice Address - Phone:205-407-4707
Practice Address - Fax:205-208-7489
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-122224163W00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse