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General NPI Number Information
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NPI Number | 1588574131
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Entity Type | Individual
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Provider Name | JESSICA LYNN EDWARDS LPN
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Gender | Female
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Dates
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Enumeration Date | 09/08/2026
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Last Update Date | 09/08/2026
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Provider Practice Location Address
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Address Line | 4614 OLD STATE RD
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City | CARTHAGE
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State | NY
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Zip | 13619-6066
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Country | US
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Telephone | 315-586-3005
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Fax |
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Provider Business Mailing Address
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Address Line | 4614 OLD STATE RD
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City | CARTHAGE
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State | NY
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Zip | 13619-6066
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Country | US
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Telephone | 315-586-3005
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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 | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 333010-01
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License Number State | NY
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