Wanda E Edwards, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

4704102153 Issued in MI

Practice address

29000 Inkster Rd
Ste 115
Southfield, MI 48034-1097

Phone

(313) 270-4888

Fax

(313) 270-4883

NPI assigned

Jul 13, 2005

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 3

Other names 1

• Wanda Eloise - Robinson Edwards Other name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wanda Edwards

  dba Health and Business Consultants

  • Psychiatric/Mental Health Nurse Practitioner
  • Southfield, MI
  • NPI 1689211823
  NPD Authorized official
• Mental Health Professionals, PC

  • Psychiatric/Mental Health Nurse Practitioner
  • W Bloomfield, MI
  • NPI 1780868380
  NPD (past)
• Psychological Institutes of Michigan, P.C.

  • Clinical Psychologist
  • Bloomfield TWP, MI
  • NPI 1447300694

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1720086697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14409 ASHTON RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482233584",
            "telephone_number": "313-837-8756",
            "fax_number": "313-270-4883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29000 INKSTER RD",
            "address_2": "STE 115",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480341097",
            "telephone_number": "313-270-4888",
            "fax_number": "313-270-4883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "WANDA",
        "middle_name": "E",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC1600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Continuing Education/Staff Development",
            "state": "MI",
            "license": "4704102153",
            "primary": false
        },
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MI",
            "license": "4704102153",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704102153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS - PROVIDER CONNECT USER ID",
            "identifier": "693558",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE - PTAN",
            "identifier": "M16694",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "0861058",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WANDA",
            "last_name": "EDWARDS",
            "middle_name": "ELOISE - ROBINSON",
            "credential": "DNP, PMHCNS-BC, NP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Quentaisja Edwards
• Robert Edwards, M.D.
• Ryan Christopher Edwards, BEHAVIOR TECHNICIAN
• Sanyani D Edwards, TLLP
• Shawn Edwards
• Anita Effinger, FNP
• Arthur A Efros, M.D.
• Theresa I Egan, PHD
• Karen E. Eggleston, D.D.S.
• Jonathan Patrick Egle, M.D.

• Psychiatric/Mental Health Nurse Practitioner in Southfield, MI
• Providers in Southfield, MI by specialty
• Psychiatric/Mental Health Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.