Provider Demographics
NPI:1285882456
Name:EDWARDS, DYANN M (ARNP-C)
Entity type:Individual
Prefix:
First Name:DYANN
Middle Name:M
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10611 HICKMAN RD
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50322-3731
Mailing Address - Country:US
Mailing Address - Phone:515-244-2265
Mailing Address - Fax:515-254-2272
Practice Address - Street 1:10611 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50322-3731
Practice Address - Country:US
Practice Address - Phone:515-244-2265
Practice Address - Fax:515-254-2272
Is Sole Proprietor?:No
Enumeration Date:2008-08-30
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA063467363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily