Vickie Dee Edwards, AGNP-C

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

AP129732 Issued in TX

Practice address

9900 Bren Rd E
Minnetonka, MN 55343-9664

Phone

(410) 274-0596

NPI assigned

Nov 8, 2015

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Ms. Vickie Dee Edwards Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1446940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593129600000",
    "number": "1669845038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23318 NICHOLS SAWMILL RD",
            "city": "HOCKLEY",
            "state": "TX",
            "postal_code": "774479559",
            "telephone_number": "713-628-4712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9900 BREN RD E",
            "city": "MINNETONKA",
            "state": "MN",
            "postal_code": "553439664",
            "telephone_number": "410-274-0596"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16711 Rugby Ct",
            "address_purpose": "LOCATION",
            "city": "Spring",
            "state": "TX",
            "postal_code": "773797510",
            "country_code": "US",
            "telephone_number": "713-628-4712",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "VICKIE",
        "middle_name": "DEE",
        "name_prefix": "Ms.",
        "credential": "AGNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-11-08",
        "last_updated": "2020-06-26",
        "certification_date": "2020-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "TX",
            "license": "662840",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "AP129732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICKIE",
            "last_name": "EDWARDS",
            "middle_name": "DEE",
            "prefix": "MS.",
            "credential": "AGNP",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Ihuoma Edwards
• Jannine Ivette Edwards, NP
• Kilauna Edwards, NP-C
• Sara Edwards, D.C.
• Shakari Jareece Edwards
• Hannah Egan
• Laura Jean Egan, M.A., CCC-SLP
• Ege Transportation LLC
• Alyssa Egersett, MA, LPCC
• Marybeth Kimball Gage Ehlert, MSW, LICSW

• Adult Health Nurse Practitioner in Minnetonka, MN
• Providers in Minnetonka, MN by specialty
• Adult Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2020; 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.