Provider Demographics
NPI:1427241793
Name:EDWARDS, KIMBERLY (HYGIENIST)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:HYGIENIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:USS CARL VINSON
Mailing Address - Street 2:CVN 70
Mailing Address - City:FPO
Mailing Address - State:AE
Mailing Address - Zip Code:09566 2840
Mailing Address - Country:US
Mailing Address - Phone:757-534-0783
Mailing Address - Fax:
Practice Address - Street 1:USS CARL VINSON
Practice Address - Street 2:CVN 70
Practice Address - City:FPO
Practice Address - State:AE
Practice Address - Zip Code:09566 2840
Practice Address - Country:US
Practice Address - Phone:757-534-0783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-21
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist