Healthcare Provider Details

I. General information

NPI: 1104918523
Provider Name (Legal Business Name): KATHRYN EDWARDS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2006
Last Update Date: 03/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 TVC
NASHVILLE TN
37232-0001
US

IV. Provider business mailing address

3601 TVC
NASHVILLE TN
37232-0001
US

V. Phone/Fax

Practice location:
  • Phone: 615-322-3000
  • Fax:
Mailing address:
  • Phone: 615-322-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0208X
TaxonomyPediatric Infectious Diseases Physician
License NumberMD12980
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: