Healthcare Provider Details

I. General information

NPI: 1114960762
Provider Name (Legal Business Name): ANDREA K EDWARDS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1602 DRAYTON ST
SAVANNAH GA
31401-7526
US

IV. Provider business mailing address

1602 DRAYTON ST
SAVANNAH GA
31401-7526
US

V. Phone/Fax

Practice location:
  • Phone: 912-651-3378
  • Fax: 912-651-2588
Mailing address:
  • Phone: 912-651-3378
  • Fax: 912-651-2588

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN032774
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: