| Doctor Name: | SUSAN T EDWARDS |
| NPI Number: | 1275818817 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ANP |
| License Number: | 5005363 |
| Business Practice Address: | 640 Parkwood Medical Park Elkin, NC - 286212487 |
| Business Phone Number: | 3365267997 |
| Business Fax Number: | 3365263537 |
| Mailing Address: | Po Box 249, YADKINVILLE |
| State: | NC |
| Postal Code: | 270550249 |
| Phone Number: | 3366794963 |
| Fax Number: | 3366792549 |
| NPI Enumeration Date: | 10/14/2011 |
| NPI Last Update Date: | 03/13/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | 5005363 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |