Healthcare Provider Details

I. General information

NPI: 1508313297
Provider Name (Legal Business Name): ROBERT JUSTIN COMBS PMHNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE MLC 11024
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

12500 REED HARTMAN HWY
CINCINNATI OH
45241-1892
US

V. Phone/Fax

Practice location:
  • Phone: 513-803-0375
  • Fax: 513-803-1124
Mailing address:
  • Phone: 513-547-2861
  • Fax: 513-880-0595

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.019863
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number3010748
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: