Individual
KACI EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4553 WATKINS ST, PACE, FL 32571-2511
(850) 800-2772
Mailing address
4553 WATKINS ST, PACE, FL 32571-2511
(850) 800-2772
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN5258619
FL
Other
Enumeration date
05/22/2023
Last updated
05/22/2023
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