Individual
KIMBERLY K EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
85 N GRAND AVE, FORT THOMAS, KY 41075-1793
(859) 572-3618
(859) 572-2326
Mailing address
PO BOX 18667, ERLANGER, KY 41018-0667
(513) 312-2247
(859) 572-2326
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
003842
OH
363A00000X
Physician Assistant
10003082A
IN
363A00000X
Physician Assistant
Primary
PA2473
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0093322
—
OH
05
—
300044877
—
IN
05
—
7100603110
—
KY
Enumeration date
09/18/2013
Last updated
06/21/2024
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