MEDICARE: MS. MICHELLE LYNN COMBS CRNA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	R76081	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1144270232
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE LYNN COMBS CRNA

Provider Business Mailing Address
First Line	:	414 CLAY RD
Second Line	:
City	:	SPENCER
State	:	WV
Zip	:	25276-6907
Country	:	US
Telephone Number	:	681-867-9060
Fax Number	:

Provider Business Practice Location Address
First Line	:	6225 N STATE HIGHWAY 161 STE 200
Second Line	:
City	:	IRVING
State	:	TX
Zip	:	75038-2241
Country	:	US
Telephone Number	:	214-687-0975
Fax Number	:	214-687-9319

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	09/17/2024

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