Provider Demographics
NPI:1154092781
Name:EDWARDS, KENNEDY A (BSN, RN, CCRN)
Entity type:Individual
Prefix:MR
First Name:KENNEDY
Middle Name:A
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:BSN, RN, CCRN
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:2201 SEASONS CT
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36695-8392
Mailing Address - Country:US
Mailing Address - Phone:318-267-9678
Mailing Address - Fax:
Practice Address - Street 1:601 E ROLLINS ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32803-1248
Practice Address - Country:US
Practice Address - Phone:407-303-7283
Practice Address - Fax:407-303-0347
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2025-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-166795363LA2100X
AL1-1667795163WC0200X
FLAPRN11039938363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine