Provider Demographics
NPI:1386190742
Name:EDWARDS-KING, BRITTANY (DNP, CRNA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:EDWARDS-KING
Suffix:
Gender:F
Credentials:DNP, CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 405
Mailing Address - City:PADUCAH
Mailing Address - State:KY
Mailing Address - Zip Code:42003-7914
Mailing Address - Country:US
Mailing Address - Phone:270-441-4750
Mailing Address - Fax:270-441-4770
Practice Address - Street 1:225 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 405
Practice Address - City:PADUCAH
Practice Address - State:KY
Practice Address - Zip Code:42003-7914
Practice Address - Country:US
Practice Address - Phone:270-441-4750
Practice Address - Fax:270-441-4770
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2016-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1126249163W00000X
KY3010715367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse