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General NPI Number Information
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NPI Number | 1144945643
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Entity Type | Individual
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Provider Name | VICTORIA EDWARDS PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/06/2022
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Last Update Date | 01/08/2025
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Provider Practice Location Address
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Address Line | 201 VILLAGE OAKS DR
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City | SAINT JOHNS
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State | FL
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Zip | 32259-3876
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Country | US
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Telephone | 904-240-0442
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Fax |
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Provider Business Mailing Address
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Address Line | 700 ACKERMAN RD STE 2120
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City | COLUMBUS
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State | OH
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Zip | 43202-1559
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Country | US
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Telephone | 614-293-5066
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9116604
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 50.009051RX
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License Number State | OH
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