Individual
KATRINA D EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1501 W ELK AVE, ELIZABETHTON, TN 37643-2874
(423) 282-1480
(423) 928-1353
Mailing address
PO BOX 4018, JOHNSON CITY, TN 37602-4018
(423) 282-1480
(423) 928-1353
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
158762
TN
363LF0000X
Family Nurse Practitioner
Primary
23396
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q033042
—
TN
Enumeration date
10/20/2017
Last updated
01/25/2018
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