Debra Edgeman, RN

Individual provider Active NPI Registered Nurse · Fort Smith, AR

NPI 1295235877 · NPPES record last updated Feb 20, 2018

Key facts

NPI
1295235877
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R070652 (AR)
Practice address
3111 S 70TH St
Fort Smith, AR 72903-5017
Phone
(479) 452-6650
Fax
(479) 452-5847
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
R070652ARMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R070652 AR Yes

Addresses

Primary practice location

3111 S 70TH St
Fort Smith, AR 72903-5017

Mailing address

PO Box 11818
Fort Smith, AR 72917-1818
Phone (479) 452-6650

Other providers in Fort Smith, AR

All providers in Fort Smith, AR · Registered Nurse in Arkansas

Sources for this page

Verify at the official NPI Registry.