Healthcare Provider Details

I. General information

NPI: 1457622268
Provider Name (Legal Business Name): CHRISTINE COMBS RN, CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CHRISTINE MILLER

II. Dates (important events)

Enumeration Date: 01/25/2012
Last Update Date: 01/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE. ML 5031
CINCINNATI OH
45229
US

IV. Provider business mailing address

3333 BURNET AVE. ML 2003
CINCINNATI OH
45229
US

V. Phone/Fax

Practice location:
  • Phone: 513-636-4225
  • Fax:
Mailing address:
  • Phone: 513-636-4432
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberCOA.12885-NP
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: