Individual
JENNIFER LYNN EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFA
Contact information
Practice address
120 NE GLEN OAK AVE STE 407, PEORIA, IL 61603-4301
(309) 672-5975
(309) 655-1678
Mailing address
120 NE GLEN OAK AVE STE 407, PEORIA, IL 61603-4301
(309) 672-5975
(309) 655-1678
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
238000175
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
106370
SURGICAL TECHNICIANS
IL
Enumeration date
10/26/2007
Last updated
10/26/2007
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