Provider Demographics
NPI:1356051205
Name:COBB, KENDRA LINNEA
Entity type:Individual
Prefix:
First Name:KENDRA
Middle Name:LINNEA
Last Name:COBB
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1281 YORKLAND RD APT K
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-6409
Mailing Address - Country:US
Mailing Address - Phone:614-348-2914
Mailing Address - Fax:
Practice Address - Street 1:422 CATHERINE ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45505-3716
Practice Address - Country:US
Practice Address - Phone:614-348-2914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-01
Last Update Date:2023-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No376J00000XNursing Service Related ProvidersHomemaker