Provider Demographics
NPI:1063092401
Name:NEAS, EDELYNE (APRN)
Entity type:Individual
Prefix:
First Name:EDELYNE
Middle Name:
Last Name:NEAS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1801 W SAMPLE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33064-1370
Mailing Address - Country:US
Mailing Address - Phone:954-289-1111
Mailing Address - Fax:888-365-3056
Practice Address - Street 1:1801 W SAMPLE RD STE 100
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33064-1370
Practice Address - Country:US
Practice Address - Phone:561-396-7742
Practice Address - Fax:888-365-3056
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FL11010860363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily