Provider Demographics
NPI:1710426986
Name:COMBS, SUSAN RAY (RN)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:RAY
Last Name:COMBS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:RAY
Other - Last Name:WALLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3222 HIGHWAY 1482
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:KY
Mailing Address - Zip Code:40972-6524
Mailing Address - Country:US
Mailing Address - Phone:606-981-0108
Mailing Address - Fax:
Practice Address - Street 1:3222 HIGHWAY 1482
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:KY
Practice Address - Zip Code:40972-6524
Practice Address - Country:US
Practice Address - Phone:606-981-0108
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-21
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1177041163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse