Healthcare Provider Details

I. General information

NPI: 1811239882
Provider Name (Legal Business Name): SHERI L COMBS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2013
Last Update Date: 11/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2627 RIVERSIDE AVE
JACKSONVILLE FL
32204-4712
US

IV. Provider business mailing address

PO BOX 864776
ORLANDO FL
32886-4776
US

V. Phone/Fax

Practice location:
  • Phone: 904-308-7372
  • Fax: 904-308-2908
Mailing address:
  • Phone: 904-308-7414
  • Fax: 904-308-1713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberARNP3379102
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: