Provider Demographics
NPI:1902030760
Name:COMBS, LAURA A (MS, RD, LD)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:A
Last Name:COMBS
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8812 WORMSLOE DR
Mailing Address - Street 2:
Mailing Address - City:KNIGHTDALE
Mailing Address - State:NC
Mailing Address - Zip Code:27545-7473
Mailing Address - Country:US
Mailing Address - Phone:919-266-1516
Mailing Address - Fax:
Practice Address - Street 1:8812 WORMSLOE DR
Practice Address - Street 2:
Practice Address - City:KNIGHTDALE
Practice Address - State:NC
Practice Address - Zip Code:27545-7473
Practice Address - Country:US
Practice Address - Phone:919-266-1516
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-08
Last Update Date:2009-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCL003157133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered