Khalilah Edmondson

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703106296 Issued in MI

Practice address

13930 Forrer St
Detroit, MI 48227-1741

Phone

(248) 716-4035

NPI assigned

Jun 13, 2018

Last updated

Jun 13, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528848000000",
    "number": "1245723212",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20110 CHERRYLAWN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482211105",
            "telephone_number": "313-409-0469"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13930 FORRER ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482271741",
            "telephone_number": "248-716-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDMONDSON",
        "first_name": "KHALILAH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-13",
        "last_updated": "2018-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703106296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antionette Edler, DO
• Susan Edlibi, M.D.
• Edmond & Williams Co.LLC
• Alisa Edmonds-Hatten
• Alandis De'Ersula Edmonds
• Claudia Nicole Edmonson, SST, HSA
• Educating U4 Life CDC
• Edward a Clay MD PC
• Edward G Kroll,DDS and Associates, PC
• Edward Roberts PLLC

• Licensed Practical Nurse in Detroit, MI
• Providers in Detroit, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.