Individual
KAITLYN NICOLE EDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2549 HACKMANN RD, SAINT CHARLES, MO 63303-5452
(636) 851-4900
Mailing address
10717 SAINT BERNARD LN, SAINT ANN, MO 63074-2519
(314) 625-1802
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096005299
IL
2255A2300X
Athletic Trainer
Primary
2020035528
MO
Other
Enumeration date
04/02/2019
Last updated
06/18/2025
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