MEDICARE: MRS. SHAYLEECE EDWARDS NP

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
1	363LF0000X	Family Nurse Practitioner	RN295523	GA

General Provider Information

NPI Number	:	1659256857
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHAYLEECE EDWARDS NP

Provider Business Mailing Address
First Line	:	704 BREEDLOVE DR
Second Line	:
City	:	MONROE
State	:	GA
Zip	:	30655-2054
Country	:	US
Telephone Number	:	888-772-0076
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 BREEDLOVE DR
Second Line	:
City	:	MONROE
State	:	GA
Zip	:	30655-2054
Country	:	US
Telephone Number	:	888-772-0076
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2025
Last Update Date	:	12/06/2025

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