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General NPI Number Information
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NPI Number | 1265244115
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Entity Type | Individual
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Provider Name | EDWARD CAUDILL MSN, FNP-C
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Gender | Male
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 11022 N 28TH DR STE 270
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City | PHOENIX
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State | AZ
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Zip | 85029-5639
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Country | US
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Telephone | 623-404-8505
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Fax | 602-429-8475
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Provider Business Mailing Address
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Address Line | 11022 N 28TH DR STE 270
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City | PHOENIX
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State | AZ
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Zip | 85029-5639
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Country | US
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Telephone | 623-404-8505
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Fax | 602-429-8475
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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 | 253121
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License Number State | AZ
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