MEDICARE: MISS GLORIA ANN COMBS

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	374700000X	Technician	20-0691R09	NC
2	376K00000X	Nurse's Aide	22727	NC

General Provider Information

NPI Number	:	1770836587
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS GLORIA ANN COMBS

Provider Business Mailing Address
First Line	:	1699 WEEKSVILLE RD
Second Line	:	106 D
City	:	ELIZABETH CTY
State	:	NC
Zip	:	27909-7939
Country	:	US
Telephone Number	:	252-505-1453
Fax Number	:

Provider Business Practice Location Address
First Line	:	1699 WEEKSVILLE RD
Second Line	:	106 D
City	:	ELIZABETH CTY
State	:	NC
Zip	:	27909-7939
Country	:	US
Telephone Number	:	252-505-1453
Fax Number	:

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

Provider Enumeration Date	:	10/17/2012
Last Update Date	:	10/17/2012

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Directions to “ MISS GLORIA ANN COMBS ” Practice Location

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