Healthcare Provider Details

I. General information

NPI: 1487730396
Provider Name (Legal Business Name): EDITH MARGARET D'AQUILA-LLOYD FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 12/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13A BIRMINGHAM ST
WRIGHTSVILLE BEACH NC
28480-2845
US

IV. Provider business mailing address

212 ALEXANDER PL
WILMINGTON NC
28411-9139
US

V. Phone/Fax

Practice location:
  • Phone: 423-598-2200
  • Fax: 910-406-5686
Mailing address:
  • Phone: 910-448-0638
  • Fax: 910-406-5686

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberARNP9230325
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number200934
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: