Provider Demographics
NPI:1659256857
Name:EDWARDS, SHAYLEECE (NP)
Entity type:Individual
Prefix:MRS
First Name:SHAYLEECE
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:SHAYLEECE
Other - Middle Name:
Other - Last Name:GRAHAM-HARGROVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:704 BREEDLOVE DR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-2054
Mailing Address - Country:US
Mailing Address - Phone:888-772-0076
Mailing Address - Fax:
Practice Address - Street 1:704 BREEDLOVE DR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:GA
Practice Address - Zip Code:30655-2054
Practice Address - Country:US
Practice Address - Phone:888-772-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-07
Last Update Date:2025-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN295523363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily