Individual
MS. NANCY PATRICIA EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
180 CENTRE ST, BROCKTON, MA 02302-2733
(508) 586-6300
(508) 580-1527
Mailing address
180 CENTRE ST, BROCKTON, MA 02302-2733
(508) 586-6300
(508) 580-1527
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
58
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58
COMMONWEALTH OF MASSACHUSETTS
MA
Enumeration date
07/18/2017
Last updated
07/21/2022
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