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General NPI Number Information
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NPI Number | 1336825975
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Entity Type | Individual
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Provider Name | OLIVIA EDWARDS PA-C
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Gender | Female
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Dates
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Enumeration Date | 06/27/2023
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Last Update Date | 07/25/2024
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Provider Practice Location Address
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Address Line | 983 BOSTON-PROVIDENCE TURNPIKE
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City | DEDHAM
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State | MA
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Zip | 02026
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Country | US
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Telephone | 781-819-6400
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Fax | 339-234-6921
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Provider Business Mailing Address
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Address Line | 360 US HIGHWAY 1 BYP UNIT 102
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City | PORTSMOUTH
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State | NH
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Zip | 03801-7105
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Country | US
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Telephone | 603-410-6700
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Fax | 603-319-8308
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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 | PA9550
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License Number State | MA
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