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General NPI Number Information
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NPI Number | 1154669372
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Entity Type | Individual
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Provider Name | NORDIA EDWARDS NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 01/23/2013
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 25925 149TH AVE FL 1
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City | ROSEDALE
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State | NY
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Zip | 11422-3003
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Country | US
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Telephone | 347-673-4090
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Fax |
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Provider Business Mailing Address
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Address Line | 25925 149TH AVE FL 1
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City | ROSEDALE
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State | NY
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Zip | 11422-3003
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Country | US
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Telephone | 347-673-4090
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | F312002
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | F312002
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License Number State | NY
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