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General NPI Number Information
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NPI Number | 1649825704
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Entity Type | Individual
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Provider Name | NATASHA BROOKE EDWARDS APRN-FNP
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Gender | Female
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Dates
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Enumeration Date | 08/06/2019
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Last Update Date | 08/06/2019
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Provider Practice Location Address
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Address Line | 2705 HIGHWAY 28 E STE B
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City | PINEVILLE
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State | LA
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Zip | 71360-5712
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Country | US
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Telephone | 318-704-6770
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Fax |
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Provider Business Mailing Address
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Address Line | 5445 PROVINE PL APT 1613
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City | ALEXANDRIA
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State | LA
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Zip | 71303-3968
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Country | US
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Telephone | 318-955-1574
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 207293
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License Number State | LA
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