Provider Demographics
NPI:1982998191
Name:EDWARDS, NANCY P (RPH)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:P
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8720 QUIMPER PL STE 300
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71105-5742
Mailing Address - Country:US
Mailing Address - Phone:318-671-9603
Mailing Address - Fax:318-671-1106
Practice Address - Street 1:8720 QUIMPER PL STE 300
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71105-5742
Practice Address - Country:US
Practice Address - Phone:318-671-9603
Practice Address - Fax:318-671-1106
Is Sole Proprietor?:No
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA101031835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric