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Individual
TANYA EDMONDS
Active
Individual
TANYA EDMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2029684
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20098018
—
KY
Enumeration date
06/02/2009
Last updated
06/02/2009
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