MEDICARE: MICHELLE LEE EDWARDS

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	237700000X	Hearing Instrument Specialist

General Provider Information

NPI Number	:	1184498123
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELLE LEE EDWARDS

Provider Business Mailing Address
First Line	:	5725 JOHNSTON ST STE 502
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70503-5307
Country	:	US
Telephone Number	:	337-704-2228
Fax Number	:

Provider Business Practice Location Address
First Line	:	2102 MACARTHUR DR STE C
Second Line	:
City	:	ALEXANDRIA
State	:	LA
Zip	:	71301-3763
Country	:	US
Telephone Number	:	337-704-2228
Fax Number	:

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

Provider Enumeration Date	:	11/09/2023
Last Update Date	:	11/09/2023

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Directions to “ MICHELLE LEE EDWARDS ” Practice Location

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