Provider Demographics
NPI:1477257459
Name:SMITH-MCCOMBS, KENDALL LEE
Entity type:Individual
Prefix:
First Name:KENDALL
Middle Name:LEE
Last Name:SMITH-MCCOMBS
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 1:141 PARKER AVE
Mailing Address - Street 2:
Mailing Address - City:MAPLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07040-1831
Mailing Address - Country:US
Mailing Address - Phone:862-205-1063
Mailing Address - Fax:
Practice Address - Street 1:141 PARKER AVE
Practice Address - Street 2:
Practice Address - City:MAPLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07040-1831
Practice Address - Country:US
Practice Address - Phone:862-205-1063
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula