Provider Demographics
NPI:1235386269
Name:GARCIA-KELLEY, EDNA (RN)
Entity Type:Individual
Prefix:
First Name:EDNA
Middle Name:
Last Name:GARCIA-KELLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:BOX 1487
Mailing Address - Street 2:CMR 416
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09140
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:CMR 416
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09140
Practice Address - Country:US
Practice Address - Phone:49984-183-5136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2008-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI45099163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse