Misty Edwards
Individual provider Active NPI Pharmacist · Grenada, MS
NPI 1992309520 · NPPES record last updated Nov 24, 2020
Key facts
- NPI
- 1992309520
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- E-09460 (MS)
- Practice address
- 1655 Sunset Dr
Grenada, MS 38901-4061 - Phone
- (662) 226-6550
- NPI assigned
- Nov 24, 2020
- 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 |
|---|---|---|---|
| E-09460 | MS | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-09460 | MS | Yes |
Addresses
Primary practice location
1655 Sunset Dr
Grenada, MS 38901-4061
Mailing address
481 Broadfield Dr
Grenada, MS 38901-7832
Phone (662) 809-0760
Other providers in Grenada, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 24, 2020. 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.