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General NPI Number Information
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NPI Number | 1942881008
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Entity Type | Individual
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Provider Name | HEATHER LYNNE EDWARDS DO
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Gender | Female
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 6071 W OUTER DR STE M536
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City | DETROIT
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State | MI
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Zip | 48235-2624
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Country | US
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Telephone | 313-966-1941
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Fax |
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Provider Business Mailing Address
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Address Line | 5250 NEOSHO LN
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City | ROELAND PARK
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State | KS
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Zip | 66205-1434
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Country | US
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Telephone | 913-636-7147
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 5101028282
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License Number State | MI
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