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General NPI Number Information
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NPI Number | 1922823327
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Entity Type | Individual
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Provider Name | KEREN EDISON RN
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Gender | Female
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 13681 DOCTORS WAY
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City | FORT MYERS
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State | FL
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Zip | 33912-4300
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Country | US
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Telephone | 239-343-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 1819 SW 16TH TER
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City | CAPE CORAL
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State | FL
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Zip | 33991-3172
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Country | US
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Telephone | 352-514-5404
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Fax |
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN9324777
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License Number State | FL
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