Healthcare Provider Details

I. General information

NPI: 1386400471
Provider Name (Legal Business Name): LIBBY COMBS FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2024
Last Update Date: 02/26/2024
Certification Date: 02/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1511 GUNBARREL RD STE 111
CHATTANOOGA TN
37421-3897
US

IV. Provider business mailing address

1022 STONE LEDGE LN
CHATTANOOGA TN
37421-4769
US

V. Phone/Fax

Practice location:
  • Phone: 423-553-5999
  • Fax:
Mailing address:
  • Phone: 423-402-5122
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number35777
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: