Stephanie Yolanda Edwards
Individual provider Active NPI Family Health Clinical Nurse Specialist · Rolling Fork, MS
NPI 1508525965 · NPPES record last updated Dec 14, 2021
Key facts
- NPI
- 1508525965
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Health Clinical Nurse Specialist 364SF0001X
- License
- 905048 (MS)
- Practice address
- 283 Race St, Rolling Fork, Ms 39159
Rolling Fork, MS 39159 - Phone
- (662) 873-0477
- NPI assigned
- Dec 14, 2021
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 905048 | MS | MD | Family Health Clinical Nurse Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Health Clinical Nurse Specialist | 364SF0001X | 905048 | MS | Yes |
Addresses
Primary practice location
283 Race St, Rolling Fork, Ms 39159
Rolling Fork, MS 39159
Mailing address
302 Starlite Dr
Yazoo City, MS 39194
Phone (662) 571-3171
Other providers in Rolling Fork, MS
- Delta Community Mental Health Services
- Delta Health Center, Inc.
- Kiona J Dorsey
- Dr. Danny W Jackson D.O. PA
- Angelia Michele Eason
- Elt Inc.
- Freds Stores of Tennessee Inc
- Martin Galas
- Andrew George
- Jackson Rural Health Clinic P a
All providers in Rolling Fork, MS · Family Health Clinical Nurse Specialist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 14, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.