Doctor Name: | MRS. BETHANY JANETTE EDWARDS |
NPI Number: | 1649434754 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP |
License Number: | R866714 |
Business Practice Address: | 7215 S Siwell Rd Byram, MS - 392729776 |
Business Phone Number: | 6013732204 |
Business Fax Number: | 6013734413 |
Mailing Address: | 7215 S Siwell Rd, BYRAM |
State: | MS |
Postal Code: | 392729776 |
Phone Number: | 6013732204 |
Fax Number: | 6013734413 |
NPI Enumeration Date: | 07/17/2008 |
NPI Last Update Date: | 02/12/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | R866714 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |