Provider Demographics
NPI:1124684212
Name:COMBS, KAYLA RENAE (NP-C)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:RENAE
Last Name:COMBS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:449 PINE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:HARDINSBURG
Mailing Address - State:KY
Mailing Address - Zip Code:40143-6647
Mailing Address - Country:US
Mailing Address - Phone:502-649-6219
Mailing Address - Fax:
Practice Address - Street 1:3832 TAYLORSVILLE RD UNIT 8-10
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40220-1369
Practice Address - Country:US
Practice Address - Phone:502-649-6219
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYF01190299363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily