Provider Demographics
NPI:1386301299
Name:EDWARDS, JULIETTE POWELL (APRN)
Entity type:Individual
Prefix:
First Name:JULIETTE
Middle Name:POWELL
Last Name:EDWARDS
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 1:8082 ROSE MARIE AVE W
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-1017
Mailing Address - Country:US
Mailing Address - Phone:772-342-1520
Mailing Address - Fax:
Practice Address - Street 1:8082 ROSE MARIE AVE W
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-1017
Practice Address - Country:US
Practice Address - Phone:772-342-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-27
Last Update Date:2021-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11016581363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health