MEDICARE: BRANDI LEIGH EDWARDS

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	163WD0400X	Diabetes Educator Registered Nurse	1-128322	AL

General Provider Information

NPI Number	:	1730764259
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDI LEIGH EDWARDS

Provider Business Mailing Address
First Line	:	1963 MEMORIAL PKWY SW STE 18
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5035
Country	:	US
Telephone Number	:	256-265-3066
Fax Number	:

Provider Business Practice Location Address
First Line	:	1963 MEMORIAL PKWY SW STE 18
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35801-5035
Country	:	US
Telephone Number	:	256-265-3068
Fax Number	:

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

Provider Enumeration Date	:	03/16/2021
Last Update Date	:	03/16/2021

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Directions to “ BRANDI LEIGH EDWARDS ” Practice Location

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