Edmisson, Kenneth Wayne
Edmisson, Kenneth Wayne is an sole proprietor health care provider with primary practice located at 225 Medical Center Dr #405, Paducah KY 42003-7914. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Edmisson, Kenneth Wayne can be contacted via phone (270) 441-4750.Contact Information
Primary practice address
225 Medical Center Dr #405
Paducah KY 42003-7914
Phone: (270) 441-4750
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | APN0000006429 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 0024162111 | Virginia |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 3007055 | Kentucky |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 6429 | Tennessee |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 1659 | Texas |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 12386-NA | Ohio |
Profile Details
| NPI number | 1295731081 |
|---|---|
| LBN Legal business name | Edmisson, Kenneth Wayne |
| Credentials | ND EDD RNC FNP CRNA |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 26th, 2005 |
| Last updated | Oct 4th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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