Provider Demographics
NPI:1073631990
Name:EDWARDS, NORA LEE (2215436)
Entity type:Individual
Prefix:MS
First Name:NORA
Middle Name:LEE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:2215436
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3426 WOODBURN AVE
Mailing Address - Street 2:#2
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45207
Mailing Address - Country:US
Mailing Address - Phone:513-761-0224
Mailing Address - Fax:
Practice Address - Street 1:3426 WOODBURN AVE
Practice Address - Street 2:#2
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45207
Practice Address - Country:US
Practice Address - Phone:513-761-0224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
2215436Medicare UPIN