Doctor Name: | REITA EDWARDS |
NPI Number: | 1285996348 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 033707 |
Business Practice Address: | 24705 Plaza Dr Ste A Plaquemine, LA - 707646827 |
Business Phone Number: | 2256879021 |
Business Fax Number: | 2256871892 |
Mailing Address: | 24705 Plaza Dr Ste A, PLAQUEMINE |
State: | LA |
Postal Code: | 707646827 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/13/2012 |
NPI Last Update Date: | 06/13/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 163WC1500X |
License Number: | 033707 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | LA |
Taxonomy Type: | Nursing Service Providers |
Taxonomy Classification: | Registered Nurse |
Taxonomy Specialization: | Community Health |
Taxonomy Definition: |