Provider Demographics
NPI:1912092537
Name:COMBS, RUTH ANNE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:RUTH
Middle Name:ANNE
Last Name:COMBS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 OLD WHITLEY RD
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40744-8211
Mailing Address - Country:US
Mailing Address - Phone:606-878-1219
Mailing Address - Fax:606-877-1195
Practice Address - Street 1:181 OLD WHITLEY RD
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40744-8211
Practice Address - Country:US
Practice Address - Phone:606-878-1219
Practice Address - Fax:606-877-1195
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2018-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3529P363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY78006541Medicaid
KY0701702Medicare PIN
KYP53284Medicare UPIN