Provider Demographics
NPI:1376695700
Name:HEDGES, KEVIN SCOTT (RN, CNOR, RNFA)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:SCOTT
Last Name:HEDGES
Suffix:
Gender:M
Credentials:RN, CNOR, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4406 BASKERVILLE DR
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75043-7274
Mailing Address - Country:US
Mailing Address - Phone:214-766-3454
Mailing Address - Fax:972-240-7262
Practice Address - Street 1:4406 BASKERVILLE DR
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75043-7274
Practice Address - Country:US
Practice Address - Phone:214-766-3454
Practice Address - Fax:972-240-7262
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-17
Last Update Date:2007-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX667351163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant