Healthcare Provider Details

I. General information

NPI: 1346693660
Provider Name (Legal Business Name): MARGARET BLUFORD-EDWARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2016
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 PROMENADE CIR 300
SACRAMENTO CA
95834-2939
US

IV. Provider business mailing address

180 PROMENADE CIR 300
SACRAMENTO CA
95834-2939
US

V. Phone/Fax

Practice location:
  • Phone: 916-414-9055
  • Fax: 916-414-9054
Mailing address:
  • Phone: 916-414-9055
  • Fax: 916-414-9054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number377456
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: