Individual
MRS. KIMBERLY RENEE EDENS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PA-C, MS
Contact information
Practice address
200 VETERANS AVE, BECKLEY, WV 25801-6444
(304) 255-2121
(304) 255-2431
Mailing address
1185 OLD ECCLES RD, BECKLEY, WV 25801-8813
(304) 252-0007
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1036276-NCCPA#
WV
Other
Enumeration date
05/20/2006
Last updated
07/08/2007
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