Provider Demographics
NPI:1750835633
Name:COOMBS, SHEREE
Entity Type:Individual
Prefix:
First Name:SHEREE
Middle Name:
Last Name:COOMBS
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 1:3214 HIBISCUS AVE
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34947-7265
Mailing Address - Country:US
Mailing Address - Phone:772-626-2487
Mailing Address - Fax:
Practice Address - Street 1:3214 HIBISCUS AVE
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34947-7265
Practice Address - Country:US
Practice Address - Phone:772-626-2487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-09
Last Update Date:2016-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide