Kristin Marie Edler, RN

Individual provider Active NPI Registered Nurse · Grover Beach, CA

NPI 1497936355 · NPPES record last updated Nov 20, 2007

Key facts

NPI
1497936355
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
576974 (CA)
Practice address
286 S 16TH St
Grover Beach, CA 93433-2245
Phone
(805) 473-7040
NPI assigned
Nov 20, 2007
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
576974CAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 576974 CA Yes

Addresses

Primary practice location

286 S 16TH St
Grover Beach, CA 93433-2245

Mailing address

2191 Johnson Ave
PO Box 1489
San Luis Obispo, CA 93401-4534
Phone (805) 473-7040

Other providers in Grover Beach, CA

All providers in Grover Beach, CA · Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.