Dora Cynthia Edwards, RN

Individual provider Active NPI General Practice Registered Nurse · Acton, CA

NPI 1962925008 · NPPES record last updated Jul 20, 2017

Key facts

NPI
1962925008
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Registered Nurse 163WG0000X
License
441071 (CA)
Practice address
30500 Arrastre Canyon Rd
Acton, CA 93510-2160
Phone
(661) 223-8710
Fax
(661) 269-9156
NPI assigned
Jul 20, 2017
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
441071CAMDGeneral Practice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Registered Nurse 163WG0000X 441071 CA Yes

Addresses

Primary practice location

30500 Arrastre Canyon Rd
Acton, CA 93510-2160

Mailing address

30500 Arrastre Canyon Rd
Acton, CA 93510-2160
Phone (661) 223-8710

Other providers in Acton, CA

All providers in Acton, CA · General Practice Registered Nurse in California

Sources for this page

Verify at the official NPI Registry.