Individual
MIRANDA NICOLE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
710 WELLINGTON AVE, GRAND JUNCTION, CO 81501-6123
(970) 298-6601
Mailing address
710 WELLINGTON AVE, GRAND JUNCTION, CO 81501-6123
(970) 298-6601
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125.063393
IL
208000000X
Pediatrics Physician
Primary
0059094
CO
208000000X
Pediatrics Physician
125.063393
IL
Other
Enumeration date
06/18/2013
Last updated
01/18/2021
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