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General NPI Number Information
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NPI Number | 1871115345
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Entity Type | Individual
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Provider Name | BROOKE COMBS
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Gender | Female
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Dates
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Enumeration Date | 05/07/2020
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Last Update Date | 05/07/2020
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Provider Practice Location Address
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Address Line | 200 MARABLE WAY NW
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City | ROME
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State | GA
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Zip | 30165-1387
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Country | US
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Telephone | 706-295-6035
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Fax |
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Provider Business Mailing Address
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Address Line | 7775 BASKET CREEK RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30135-6550
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Country | US
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Telephone | 678-939-6872
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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 | RN217518
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License Number State | GA
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