Individual
EDITH KWINKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
260 WINDSOR WAY, FAIRBURN, GA 30213-6497
(404) 200-1682
Mailing address
260 WINDSOR WAY, FAIRBURN, GA 30213-6497
(404) 200-1682
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
310004
GA
163WH0200X
Home Health Registered Nurse
9585284
FL
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
310004
GA
227900000X
Registered Respiratory Therapist
5977
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05252005
—
GA
Enumeration date
08/09/2022
Last updated
08/09/2022
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