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NPI Code Detail

MEDICARE: DR. JESSICA LEANN EDWARDS

MEDICARE:  DR. JESSICA LEANN 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
1183500000XPharmacistRP0007725WV

General Provider Information

NPI Number : 1982987053
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JESSICA LEANN EDWARDS
Provider Business Mailing Address
First Line : 206 WOODSTOCK PL
Second Line :
City : CHARLESTON
State : WV
Zip : 25314-1784
Country : US
Telephone Number : 304-542-7396
Fax Number :
Provider Business Practice Location Address
First Line : 4016 OHIO RIVER RD
Second Line :
City : POINT PLEASANT
State : WV
Zip : 25550-3257
Country : US
Telephone Number : 304-675-1612
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/24/2011
Last Update Date : 09/24/2011

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Directions to “ DR. JESSICA LEANN EDWARDS ” Practice Location

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