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General NPI Number Information
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NPI Number | 1467692566
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Entity Type | Individual
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Provider Name | TONI LEE EDWARDS BSN
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Gender | Female
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Dates
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Enumeration Date | 03/02/2009
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Last Update Date | 03/02/2009
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Provider Practice Location Address
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Address Line | 200 W FAIRVIEW AVE
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City | JOHNSON CITY
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State | TN
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Zip | 37604-5611
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Country | US
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Telephone | 423-467-3600
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Fax | 423-467-3644
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Provider Business Mailing Address
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Address Line | 1167 SPRATLIN PARK DR
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City | GRAY
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State | TN
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Zip | 37615-6205
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Country | US
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Telephone | 423-467-3721
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Fax | 423-467-3644
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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 | 169158
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License Number State | TN
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