Individual
CAROLYN ELIZABETH EDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN,BC,
Contact information
Practice address
1 HOSPITAL DR, COLUMBIA, MO 65212-0001
(573) 882-2273
(573) 884-4609
Mailing address
PO BOX 7687, COLUMBIA, MO 65205-7687
(573) 882-2259
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
063452
MO
363LP0200X
Pediatric Nurse Practitioner
063452
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100415160A
—
KS
05
—
423315308
—
MO
Enumeration date
04/25/2006
Last updated
10/15/2012
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