Provider Demographics
NPI:1811403439
Name:COMBS, BRIANNA (PHARMD)
Entity Type:Individual
Prefix:
First Name:BRIANNA
Middle Name:
Last Name:COMBS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 TWIN OAKS DR
Mailing Address - Street 2:
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150-3703
Mailing Address - Country:US
Mailing Address - Phone:812-989-8742
Mailing Address - Fax:
Practice Address - Street 1:2202 E SPRING ST
Practice Address - Street 2:
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150-1563
Practice Address - Country:US
Practice Address - Phone:812-949-0641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-12-19
Last Update Date:2017-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY019423183500000X
IN26027335A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist