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General NPI Number Information
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NPI Number | 1740915610
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Entity Type | Individual
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Provider Name | KRISTEN EDNEY APRN
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Gender | Female
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Dates
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Enumeration Date | 07/23/2022
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Last Update Date | 08/15/2025
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Provider Practice Location Address
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Address Line | 1133 MEDICAL DR
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City | TYLER
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State | TX
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Zip | 75701-2130
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Country | US
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Telephone | 903-595-5486
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Fax | 903-595-5128
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Provider Business Mailing Address
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Address Line | 1133 MEDICAL DR
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City | TYLER
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State | TX
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Zip | 75701-2130
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Country | US
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Telephone | 903-595-5486
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Fax | 903-595-5128
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 702888
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 1097191
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1097191
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License Number State | TX
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