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General NPI Number Information
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NPI Number | 1063910933
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Entity Type | Individual
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Provider Name | ANDY JAY EDWARDS MSN, APRN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 01/25/2018
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Last Update Date | 07/27/2023
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Provider Practice Location Address
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Address Line | 7050 UNION PARK CENTER #200
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City | MIDVALE
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State | UT
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Zip | 84047-4171
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Country | US
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Telephone | 888-562-5442
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Fax | 562-499-6171
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Provider Business Mailing Address
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Address Line | 200 OCEANGATE STE 100
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City | LONG BEACH
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State | CA
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Zip | 90802-4317
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Country | US
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Telephone | 888-562-5442
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Fax | 562-499-6171
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 8560489-4405
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 8650489-4405
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License Number State | UT
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Taxonomy #3
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 8560489-4405
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 8650489-3102
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License Number State | UT
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