Provider Demographics
NPI:1225745318
Name:COMBS, CHRISTINA MAE (RN)
Entity Type:Individual
Prefix:
First Name:CHRISTINA
Middle Name:MAE
Last Name:COMBS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 7652
Mailing Address - Street 2:
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42002-7652
Mailing Address - Country:US
Mailing Address - Phone:270-443-4743
Mailing Address - Fax:270-443-4717
Practice Address - Street 1:701 UPSHAW LN
Practice Address - Street 2:
Practice Address - City:KEVIL
Practice Address - State:KY
Practice Address - Zip Code:42053-7901
Practice Address - Country:US
Practice Address - Phone:270-443-4743
Practice Address - Fax:270-443-4717
Is Sole Proprietor?:No
Enumeration Date:2022-10-31
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041343339163W00000X
KY1093673163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse