Provider Demographics
NPI:1629230586
Name:EDMONDS, KATHERINE HOGAN (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:HOGAN
Last Name:EDMONDS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MISS
Other - First Name:KATHERINE
Other - Middle Name:E
Other - Last Name:HOGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:5417 DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37918-3456
Mailing Address - Country:US
Mailing Address - Phone:919-225-7535
Mailing Address - Fax:
Practice Address - Street 1:410 N CEDAR BLUFF RD
Practice Address - Street 2:SUITE 300
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-3623
Practice Address - Country:US
Practice Address - Phone:865-342-9011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-01
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC185390367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered