Edna Rosellen Dedlow, MSN, PNP-BC

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

5007053 Issued in NC

Practice address

719 Green Valley Rd Ste 306
Greensboro, NC 27408-7026

Phone

(336) 275-6470

Fax

(336) 275-6474

NPI assigned

Jun 12, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628553600000",
    "number": "1265474639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 GREEN VALLEY RD STE 306",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087026",
            "telephone_number": "336-275-6470",
            "fax_number": "336-275-6474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "719 GREEN VALLEY RD STE 306",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274087026",
            "telephone_number": "336-275-6470",
            "fax_number": "336-275-6474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEDLOW",
        "first_name": "EDNA",
        "middle_name": "ROSELLEN",
        "name_prefix": "Ms.",
        "credential": "MSN, PNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-12",
        "last_updated": "2021-08-10",
        "certification_date": "2021-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "5007053",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1265474639",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ededlow187898@direct.conehealth.com",
            "affiliation": "N",
            "endpointDescription": "Cone Health Direct Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "719 Green Valley Rd Ste 306",
            "city": "Greensboro",
            "state": "NC",
            "country_code": "US",
            "postal_code": "274087026",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Pediatric Nurse Practitioner in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Pediatric Nurse Practitioner in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.