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General NPI Number Information
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NPI Number | 1790176287
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Entity Type | Individual
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Provider Name | LINDSEY NICOLE EDWARDS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 02/05/2015
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Last Update Date | 08/28/2023
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Provider Practice Location Address
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Address Line | 2115 S BROADWAY AVE
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City | TYLER
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State | TX
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Zip | 75701-4214
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Country | US
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Telephone | 903-907-7002
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 846098
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City | DALLAS
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State | TX
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Zip | 75284-6098
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Country | US
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Telephone | 903-324-6450
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 741143
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP127663
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License Number State | TX
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