Provider Demographics
NPI:1396408134
Name:EDWARDS, STEPHANIE (FNP)
Entity type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:TEXOMA MEDICAL CENTER
Mailing Address - Street 2:4616 US HWY 75, SUITE 203.
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-3030
Mailing Address - Country:US
Mailing Address - Phone:903-416-6470
Mailing Address - Fax:
Practice Address - Street 1:TEXOMA MEDICAL CENTER
Practice Address - Street 2:4616 US HWY 75, SUITE 203
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020
Practice Address - Country:US
Practice Address - Phone:903-416-6470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-19
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX743164163WC0200X
TX1057172363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine