Michelle M Comboy, FNP
Individual provider Active NPI Nurse Practitioner · Luling, LA
NPI 1225115348 · NPPES record last updated Jan 6, 2011
Key facts
- NPI
- 1225115348
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 2006008070 (LA)
- Practice address
- 843 Milling Ave
Luling, LA 70070-4442 - Phone
- (985) 785-5800
- Fax
- (985) 785-5811
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070215000605 | LA | Practitioner - Nurse Practitioner | 5294737565 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2006008070 | LA | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Access Health Louisiana | Past | Accepting new patients |
Interoperability endpoints
- michelle.comboy.1@11331.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 2006008070 | LA | Yes |
Addresses
Primary practice location
843 Milling Ave
Luling, LA 70070-4442
Mailing address
843 Milling Ave
Luling, LA 70070-4442
Phone (985) 785-5800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1000361 | Medicaid | LA |
Other providers in Luling, LA
- Raymond G Campbell
- Nathaly Carrion
- Jamara Celistan
- Tina Chaisson
- Sujata Chava
- James G Comeaux
- Community Medical Group-St Charles Inc
- Ashley Cooper
- Brianne Cortez
- Lakeisha Cravin
All providers in Luling, LA · Nurse Practitioner in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.