Individual
KELLY R EDMONDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP, R.N.
Contact information
Practice address
5230 CAMPBELL BLVD, NOTTINGHAM, MD 21236-4983
(330) 263-8428
(330) 263-8190
Mailing address
9146 LENNINGS LN, BALTIMORE, MD 21237-4307
(330) 263-8428
(330) 263-8190
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
NP08869
AL
363LF0000X
Family Nurse Practitioner
Primary
R210039
MD
Other
Enumeration date
07/03/2006
Last updated
03/23/2016
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