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General NPI Number Information
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NPI Number | 1710778766
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Entity Type | Individual
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Provider Name | BENJAMIN C EDWARDS RN
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Gender | Male
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Dates
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Enumeration Date | 05/16/2025
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Last Update Date | 05/16/2025
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Provider Practice Location Address
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Address Line | 8921 S MINGO RD
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City | TULSA
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State | OK
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Zip | 74133-5841
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Country | US
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Telephone | 918-577-3699
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Fax |
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Provider Business Mailing Address
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Address Line | 13602 E 90TH CT N
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City | OWASSO
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State | OK
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Zip | 74055-2094
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Country | US
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Telephone | 918-527-1655
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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 | 163WP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Registered Nurse
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License Number | 91198
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License Number State | OK
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