Healthcare Provider Details

I. General information

NPI: 1083529234
Provider Name (Legal Business Name): VERA EDGEWORTH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2026
Last Update Date: 08/14/2026
Certification Date: 08/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9643 W REEVES RD
SPENCER IN
47460-9204
US

IV. Provider business mailing address

9643 W REEVES RD
SPENCER IN
47460-9204
US

V. Phone/Fax

Practice location:
  • Phone: 812-369-8501
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: