Stephanie Yolanda Edwards

Primary specialty

Family Health Clinical Nurse SpecialistTaxonomy code 364SF0001X

License

905048 Issued in MS

Practice address

283 Race St, Rolling Fork, Ms 39159
Rolling Fork, MS 39159

Phone

(662) 873-0477

NPI assigned

Dec 14, 2021

Last updated

Dec 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639440000000",
    "number": "1508525965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 STARLITE DR",
            "city": "YAZOO CITY",
            "state": "MS",
            "postal_code": "39194",
            "telephone_number": "662-571-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 RACE ST, ROLLING FORK, MS 39159",
            "city": "ROLLING FORK",
            "state": "MS",
            "postal_code": "39159",
            "telephone_number": "662-873-0477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "STEPHANIE",
        "middle_name": "YOLANDA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-14",
        "last_updated": "2021-12-14",
        "certification_date": "2021-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SF0001X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Family Health",
            "state": "MS",
            "license": "905048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Health Clinical Nurse Specialist in Rolling Fork, MS
• Providers in Rolling Fork, MS by specialty
• Family Health Clinical Nurse Specialist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.