Provider Demographics
NPI:1659135382
Name:EDENS, EMILEE
Entity Type:Individual
Prefix:
First Name:EMILEE
Middle Name:
Last Name:EDENS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1929 SHAWHAN RD
Mailing Address - Street 2:
Mailing Address - City:MORROW
Mailing Address - State:OH
Mailing Address - Zip Code:45152-9691
Mailing Address - Country:US
Mailing Address - Phone:513-304-9494
Mailing Address - Fax:
Practice Address - Street 1:1929 SHAWHAN RD
Practice Address - Street 2:
Practice Address - City:MORROW
Practice Address - State:OH
Practice Address - Zip Code:45152-9691
Practice Address - Country:US
Practice Address - Phone:513-304-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No172A00000XOther Service ProvidersDriver
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant