Healthcare Provider Details

I. General information

NPI: 1275909525
Provider Name (Legal Business Name): KONEECHIA CHARMAINE EDWARDS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KONEECHIA CHARMAINE BROWN FNP-C, AGACNP-BC

II. Dates (important events)

Enumeration Date: 08/20/2015
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1157 W LACEY BLVD
HANFORD CA
93230-4342
US

IV. Provider business mailing address

1157 W LACEY BLVD
HANFORD CA
93230-4342
US

V. Phone/Fax

Practice location:
  • Phone: 559-583-4024
  • Fax: 888-355-9551
Mailing address:
  • Phone: 559-583-4024
  • Fax: 888-355-9551

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number789677
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95002883
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: