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General NPI Number Information
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NPI Number | 1003612649
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Entity Type | Individual
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Provider Name | JONATHAN D COMBS APRN
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Gender | Male
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 1908 N MAIN ST
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City | HAZARD
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State | KY
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Zip | 41701-2505
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Country | US
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Telephone | 606-439-2662
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 959
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City | HAZARD
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State | KY
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Zip | 41702-0959
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Country | US
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Telephone | 606-435-2961
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4033971
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License Number State | KY
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