Individual
SANDRA EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
920 FREDERICA ST STE 204, OWENSBORO, KY 42301-3077
(270) 574-5600
(270) 574-5609
Mailing address
PO BOX 22619, OWENSBORO, KY 42303
(270) 574-5600
(270) 574-5609
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71010785A
IN
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
3014693
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100689400
—
KY
Enumeration date
06/12/2020
Last updated
11/20/2024
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