Provider Demographics
NPI:1710090436
Name:EDWARDS, KATHRYN GWIN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:GWIN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2025 ST. MARY'S ST
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27608
Mailing Address - Country:US
Mailing Address - Phone:919-832-8787
Mailing Address - Fax:919-733-1544
Practice Address - Street 1:DOROTHEA DIX HOSPITAL
Practice Address - Street 2:3601 MAIL SERVICE CENTER
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27699-3601
Practice Address - Country:US
Practice Address - Phone:919-733-5266
Practice Address - Fax:919-733-1544
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC055241835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric