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General NPI Number Information
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NPI Number | 1326679184
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Entity Type | Individual
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Provider Name | JAYDA EDGAR
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Gender | Female
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Dates
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Enumeration Date | 01/30/2020
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 205 S HANOVER ST
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City | HANOVER
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State | KS
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Zip | 66945-8924
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Country | US
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Telephone | 402-768-6041
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Fax |
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Provider Business Mailing Address
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Address Line | 205 S HANOVER ST
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City | HANOVER
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State | KS
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Zip | 66945-8924
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Country | US
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Telephone | 402-768-6041
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 121929
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 75605
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5380296032
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License Number State | KS
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