Healthcare Provider Details

I. General information

NPI: 1942028923
Provider Name (Legal Business Name): EDNA COMBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2024
Last Update Date: 09/30/2024
Certification Date: 09/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 LEON COURT
ARNETT WV
25007
US

IV. Provider business mailing address

PO BOX 53
ARNETT WV
25007-0053
US

V. Phone/Fax

Practice location:
  • Phone: 304-934-8186
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: