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NPI Code Detail

MEDICARE: TENNISHA EDWARDS DNP, CPNP-PC

MEDICARE:   TENNISHA  EDWARDS  DNP, CPNP-PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0200XPediatric Registered Nurse630137NY
2163WP0200XPediatric Registered NurseRN261933GA
3363L00000XNurse PractitionerRN261933GA
4363L00000XNurse Practitioner382456NY
5363LP0200XPediatric Nurse Practitioner382456NY
6363LP0200XPediatric Nurse PractitionerRN261933GA

General Provider Information

NPI Number : 1174935803
Entity Type Code : Individual
Provider Name (Legal Business Name) : TENNISHA EDWARDS DNP, CPNP-PC
Provider Business Mailing Address
First Line : 4449 NORTHSIDE PKWY NW APT 334
Second Line :
City : ATLANTA
State : GA
Zip : 30327-5250
Country : US
Telephone Number : 585-752-9696
Fax Number :
Provider Business Practice Location Address
First Line : 3455 PEACHTREE RD NE STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30326-3236
Country : US
Telephone Number : 914-919-9200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2014
Last Update Date : 04/15/2025

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Directions to “ TENNISHA EDWARDS DNP, CPNP-PC” Practice Location

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