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General NPI Number Information
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NPI Number | 1932451366
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Entity Type | Individual
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Provider Name | JENNIFER CORRINE EDWARDS PHARMD
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Gender | Female
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Dates
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Enumeration Date | 10/09/2012
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Last Update Date | 10/09/2012
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Provider Practice Location Address
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Address Line | 13304 LEESVILLE CHURCH RD
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City | RALEIGH
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State | NC
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Zip | 27617-5206
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Country | US
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Telephone | 919-845-5276
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Fax |
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Provider Business Mailing Address
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Address Line | 10020 PINEVILLE RD UNIT #108
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City | RALEIGH
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State | NC
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Zip | 27617-6326
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Country | US
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Telephone | 423-782-6993
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 22629
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License Number State | NC
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