Individual
KELLY L EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4054 STATE ROUTE 52, YOUNGSVILLE, NY 12791-0595
(845) 482-4800
Mailing address
PO BOX 595, YOUNGSVILLE, NY 12791-0595
(845) 482-4800
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
F306511-1
NY
Other
Enumeration date
05/14/2013
Last updated
10/18/2016
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