| Doctor Name: | DR. EDNA JACQUELINE PRINCE |
| NPI Number: | 1225230402 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | M.D. |
| License Number: | 17426 |
| Business Practice Address: | 1400 Dale Bumpers Road Fcc Forrest City Forrest City, AR - 72336 |
| Business Phone Number: | 8706306000 |
| Business Fax Number: | |
| Mailing Address: | 2093 Hallwood Dr, MEMPHIS |
| State: | TN |
| Postal Code: | 381074704 |
| Phone Number: | 9012767169 |
| Fax Number: | |
| NPI Enumeration Date: | 06/01/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 17426 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TN |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |