Provider Demographics
NPI:1992594485
Name:EDWARDS, KELSEY MARIE (SBD)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:MARIE
Last Name:EDWARDS
Suffix:
Gender:
Credentials:SBD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 W LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:MILLERSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46543-9767
Mailing Address - Country:US
Mailing Address - Phone:269-362-0760
Mailing Address - Fax:
Practice Address - Street 1:200 W LINCOLN ST
Practice Address - Street 2:
Practice Address - City:MILLERSBURG
Practice Address - State:IN
Practice Address - Zip Code:46543-9767
Practice Address - Country:US
Practice Address - Phone:269-362-0760
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty