MEDICARE: MS. KIMBERLY DARLENE EADIE NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RP1001X	Pulmonary Disease Physician	APRN11024543	FL
2	363LP2300X	Primary Care Nurse Practitioner	7565	CT

General Provider Information

NPI Number	:	1952630451
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KIMBERLY DARLENE EADIE NP-C

Provider Business Mailing Address
First Line	:	4224 FAWN MEADOWS CIR
Second Line	:
City	:	CLERMONT
State	:	FL
Zip	:	34711-5331
Country	:	US
Telephone Number	:	248-494-0014
Fax Number	:

Provider Business Practice Location Address
First Line	:	10101 W COLONIAL DR STE 102
Second Line	:
City	:	OCOEE
State	:	FL
Zip	:	34761-4213
Country	:	US
Telephone Number	:	407-895-9060
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/11/2009
Last Update Date	:	03/16/2026

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