Healthcare Provider Details

I. General information

NPI: 1861306862
Provider Name (Legal Business Name): NANCY ANGELA EDSON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ANNIE EDSON

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104A VILLA WAY
PITTSBURG KS
66762-4562
US

IV. Provider business mailing address

104A VILLA WAY
PITTSBURG KS
66762-4562
US

V. Phone/Fax

Practice location:
  • Phone: 620-238-0010
  • Fax:
Mailing address:
  • Phone: 620-238-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: