Provider Demographics
NPI:1568909570
Name:EDMOND, VERNICIA A (CRNP)
Entity type:Individual
Prefix:MRS
First Name:VERNICIA
Middle Name:A
Last Name:EDMOND
Suffix:
Gender:
Credentials:CRNP
Other - Prefix:MS
Other - First Name:VERNICIA
Other - Middle Name:A
Other - Last Name:VALENTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP-BC, CHHP
Mailing Address - Street 1:2490 MARKET ST NE STE G
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20018-3851
Mailing Address - Country:US
Mailing Address - Phone:240-310-9289
Mailing Address - Fax:
Practice Address - Street 1:5600 RIVERTECH CT STE G
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:MD
Practice Address - Zip Code:20737-1354
Practice Address - Country:US
Practice Address - Phone:301-310-9289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-28
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
261QH0100X, 261QX0100X
DCRN1014617363LF0000X
MDR182544363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine