Individual
EDWIN PAUL STAAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
200 HOME RD, COVINGTON, KY 41011-1942
(859) 261-8768
(859) 291-2431
Mailing address
200 HOME RD, COVINGTON, KY 41011-1942
(859) 261-8768
(859) 291-2431
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3003831
KY
363LA2200X
Adult Health Nurse Practitioner
P3831
KY
363LF0000X
Family Nurse Practitioner
16864-NP
OH
363LF0000X
Family Nurse Practitioner
P3003831
KY
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
P3831
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
610661458
TAX ID
KY
Enumeration date
07/13/2006
Last updated
01/14/2026
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