Provider Demographics
NPI:1982574083
Name:EDWARDS, BRANDY JO (APRN)
Entity type:Individual
Prefix:
First Name:BRANDY
Middle Name:JO
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:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:AUGUSTA
Mailing Address - State:AR
Mailing Address - Zip Code:72006-0497
Mailing Address - Country:US
Mailing Address - Phone:870-347-2534
Mailing Address - Fax:870-301-2092
Practice Address - Street 1:11720 SR 27
Practice Address - Street 2:
Practice Address - City:HECTOR
Practice Address - State:AR
Practice Address - Zip Code:72843-8712
Practice Address - Country:US
Practice Address - Phone:479-284-2127
Practice Address - Fax:479-284-2130
Is Sole Proprietor?:No
Enumeration Date:2025-11-05
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR087793363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner