Healthcare Provider Details

I. General information

NPI: 1053225565
Provider Name (Legal Business Name): ANN EDWARDS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1415 LAKESIDE CT STE 102
YAKIMA WA
98902-7300
US

IV. Provider business mailing address

420 S 72ND AVE STE 180-114
YAKIMA WA
98908-1688
US

V. Phone/Fax

Practice location:
  • Phone: 509-823-7823
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP.AP.70181479-NP
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: