Provider Demographics
NPI:1942028923
Name:COMBS, EDNA
Entity type:Individual
Prefix:
First Name:EDNA
Middle Name:
Last Name:COMBS
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:PO BOX 53
Mailing Address - Street 2:
Mailing Address - City:ARNETT
Mailing Address - State:WV
Mailing Address - Zip Code:25007-0053
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:111 LEON COURT
Practice Address - Street 2:
Practice Address - City:ARNETT
Practice Address - State:WV
Practice Address - Zip Code:25007
Practice Address - Country:US
Practice Address - Phone:304-934-8186
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide