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General NPI Number Information
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NPI Number | 1952257495
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Entity Type | Individual
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Provider Name | JERNIER EDWARDS
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Gender | Female
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Dates
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Enumeration Date | 03/06/2026
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Last Update Date | 03/06/2026
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Provider Practice Location Address
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Address Line | 2177 OAK TREE RD STE 206
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City | EDISON
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State | NJ
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Zip | 08820-1082
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Country | US
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Telephone | 848-372-5930
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Fax |
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Provider Business Mailing Address
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Address Line | 5422 BARLEYCORN DR
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City | RICHMOND
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State | VA
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Zip | 23227-2559
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Country | US
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Telephone |
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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 | 2083A0300X
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Taxonomy Name | Addiction Medicine (Preventive Medicine) Physician
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License Number | 25MA08065400
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License Number State | NJ
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