=====================================================
General NPI Number Information
=====================================================
NPI Number | 1669381760
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | IRON EDGE HEALTH NURSING CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/03/2026
-----------------------------------------------------
Last Update Date | 09/03/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2108 N ST STE N
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95816-5712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-559-0558
-----------------------------------------------------
Fax | 743-244-2879
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3130 BALFOUR RD STE D #249
-----------------------------------------------------
City | BRENTWOOD
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94513-5516
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 925-559-0558
-----------------------------------------------------
Fax | 743-244-2879
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DEIDRA LAVERNE FRANCIS-LOFTON
-----------------------------------------------------
Credential | FNP-C
-----------------------------------------------------
Telephone | 925-559-0558
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------