Provider Demographics
NPI:1407093529
Name:EDWARDS, KATHRYN VIOLET (RN, CPNP)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:VIOLET
Last Name:EDWARDS
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Gender:F
Credentials:RN, CPNP
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Mailing Address - Street 1:22 RED JACKET ST
Mailing Address - Street 2:P.O. BOX 499
Mailing Address - City:DANSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14437-9502
Mailing Address - Country:US
Mailing Address - Phone:585-335-5200
Mailing Address - Fax:585-335-5037
Practice Address - Street 1:22 RED JACKET ST
Practice Address - Street 2:
Practice Address - City:DANSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14437-9502
Practice Address - Country:US
Practice Address - Phone:585-335-5200
Practice Address - Fax:585-335-5037
Is Sole Proprietor?:No
Enumeration Date:2009-01-12
Last Update Date:2018-09-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY381979363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics