Edmisson, Kenneth Wayne

Edmisson, Kenneth Wayne is an sole proprietor health care provider with primary practice located at 225 Medical Center Dr #405, Paducah KY 42003-7914. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered. Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered is his primary health care specialty. Edmisson, Kenneth Wayne can be contacted via phone (270) 441-4750.

Contact Information

Primary practice address
225 Medical Center Dr #405 Paducah KY 42003-7914
Phone: (270) 441-4750
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X APN0000006429 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024162111 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 3007055 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 6429 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 1659 Texas
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 12386-NA Ohio

Profile Details

NPI number 1295731081
LBN Legal business name Edmisson, Kenneth Wayne
Credentials ND EDD RNC FNP CRNA
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 26th, 2005
Last updated Oct 4th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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