Provider Demographics
NPI:1528930096
Name:ROLAND-EDMONDSON, KIMBERLY CHERIE (RN)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:CHERIE
Last Name:ROLAND-EDMONDSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2302 DARTMOUTH DR
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-1306
Mailing Address - Country:US
Mailing Address - Phone:580-304-2739
Mailing Address - Fax:
Practice Address - Street 1:2302 DARTMOUTH DR
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75052-1306
Practice Address - Country:US
Practice Address - Phone:580-304-2739
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX897180163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency