Healthcare Provider Details

I. General information

NPI: 1447197892
Provider Name (Legal Business Name): JULIA C EDWARDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

671 SW MAIN ST
WINSTON OR
97496-6571
US

IV. Provider business mailing address

PO BOX 1121
ROSEBURG OR
97470-0254
US

V. Phone/Fax

Practice location:
  • Phone: 541-492-4550
  • Fax: 541-492-4556
Mailing address:
  • Phone: 541-672-2691
  • Fax: 541-440-3554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN9511450
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: