Provider Demographics
NPI:1588637961
Name:COMBS, GINGER RENEE (ARNP RN)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:RENEE
Last Name:COMBS
Suffix:
Gender:F
Credentials:ARNP RN
Other - Prefix:
Other - First Name:GINGER
Other - Middle Name:RENEE
Other - Last Name:FITZGERALD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:55 THANNOLI DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503
Mailing Address - Country:US
Mailing Address - Phone:606-677-0854
Mailing Address - Fax:606-677-9311
Practice Address - Street 1:55 THANNOLI DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503
Practice Address - Country:US
Practice Address - Phone:606-677-0854
Practice Address - Fax:606-677-9311
Is Sole Proprietor?:No
Enumeration Date:2006-02-08
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1063460207RC0000X
KY4692P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000484546OtherBLUE CROSS
KYDF2752OtherRAILROAD MEDICARE GROUP
KY000000061076OtherBCBS GROUP #
KY170705992OtherCHAMPUS
KY1230028OtherCHA
KY78016540Medicaid
KYP00352211OtherRAILROAD MEDICARE
KY010009800OtherFEDERAL BLACK LUNG
KY1518921OtherUMWA
KY170705992OtherTRICARE
KYP00352211OtherRAILROAD MEDICARE
KY6807Medicare ID - Type UnspecifiedMEDICARE GROUP
KY78016540Medicaid