Healthcare Provider Details

I. General information

NPI: 1023553070
Provider Name (Legal Business Name): TONI EDWARDS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2016
Last Update Date: 12/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

232 S WOODS MILL RD
CHESTERFIELD MO
63017-3406
US

IV. Provider business mailing address

232 S WOODS MILL RD
CHESTERFIELD MO
63017-3406
US

V. Phone/Fax

Practice location:
  • Phone: 314-878-2888
  • Fax:
Mailing address:
  • Phone: 314-878-2888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF1116244
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: