Provider Demographics
NPI:1942643598
Name:EDWARDS, KEAPLISH DANELL (STNA)
Entity Type:Individual
Prefix:MRS
First Name:KEAPLISH
Middle Name:DANELL
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:STNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:436 LINDENWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-1306
Mailing Address - Country:US
Mailing Address - Phone:937-270-1864
Mailing Address - Fax:
Practice Address - Street 1:436 LINDENWOOD RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-1306
Practice Address - Country:US
Practice Address - Phone:937-270-1864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-14
Last Update Date:2013-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401495940313374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide