Healthcare Provider Details

I. General information

NPI: 1902884448
Provider Name (Legal Business Name): SHERYL E COMBS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 WASHINGTON ST
HARTFORD CT
06106-3322
US

IV. Provider business mailing address

264 TURNAGE ST NW
SALEM OR
97304-4519
US

V. Phone/Fax

Practice location:
  • Phone: 860-837-7250
  • Fax: 860-837-6970
Mailing address:
  • Phone: 203-980-8786
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number003227
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3227
License Number StateCT
# 3
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number3227
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: