Provider Demographics
NPI:1508251448
Name:HOLCOMBE, CINDY
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:HOLCOMBE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5793 ANTELOPE TRL
Mailing Address - Street 2:
Mailing Address - City:COLLEGE PARK
Mailing Address - State:GA
Mailing Address - Zip Code:30349-6909
Mailing Address - Country:US
Mailing Address - Phone:404-287-3334
Mailing Address - Fax:
Practice Address - Street 1:5793 ANTELOPE TRL
Practice Address - Street 2:
Practice Address - City:COLLEGE PARK
Practice Address - State:GA
Practice Address - Zip Code:30349-6909
Practice Address - Country:US
Practice Address - Phone:404-287-3334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2015-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACN0030035174376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide