Carolyn N Edwards-Nelson, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

058934 Issued in MO

Practice address

1109 Jones St
Kennett, MO 63857

Phone

(573) 888-5925

NPI assigned

Dec 1, 2015

Last updated

May 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Carrie N Edwards Professional name

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": "1448928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1477928570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1109 JONES ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573824",
            "telephone_number": "573-888-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1109 JONES ST",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "63857",
            "telephone_number": "573-888-5925"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 Ely St",
            "address_purpose": "LOCATION",
            "city": "Kennett",
            "state": "MO",
            "postal_code": "638571336",
            "country_code": "US",
            "telephone_number": "573-888-5925 x1401",
            "fax_number": "573-717-7059",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS-NELSON",
        "first_name": "CAROLYN",
        "middle_name": "N",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-01",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MO",
            "license": "058934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "EDWARDS",
            "middle_name": "N",
            "credential": "LPN",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Dunklin Day Activity Center
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• David Eichler
• Samuel Arthur Elliott
• Dakota Lane Coriene Ellis
• Lyndsey Ellis
• Tanya Ellis

• Licensed Practical Nurse in Kennett, MO
• Providers in Kennett, MO by specialty
• Licensed Practical Nurse in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 9, 2019; 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.