Provider Demographics
NPI:1013190966
Name:LACOMBE-KERN, DAWN L (CA)
Entity Type:Individual
Prefix:
First Name:DAWN
Middle Name:L
Last Name:LACOMBE-KERN
Suffix:
Gender:F
Credentials:CA
Other - Prefix:
Other - First Name:DAWN
Other - Middle Name:L
Other - Last Name:LACOMBE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CA
Mailing Address - Street 1:25 WHITE OAK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:LINCROFT
Mailing Address - State:NJ
Mailing Address - Zip Code:07738-1006
Mailing Address - Country:US
Mailing Address - Phone:732-842-8144
Mailing Address - Fax:
Practice Address - Street 1:200 HIGHWAY 34 N
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1234
Practice Address - Country:US
Practice Address - Phone:732-842-8144
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-14
Last Update Date:2007-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00057000171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist