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LAVONDIA EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
11133 DUNN RD, SAINT LOUIS, MO 63136-6119
(314) 653-5000
(314) 317-0606
Mailing address
12101 WOODCREST EXECUTIVE DR, SUITE 210, SAINT LOUIS, MO 63141-5047
(314) 317-0600
(314) 317-0606

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
154318
MO
363LF0000X
Family Nurse Practitioner
Primary
2010001250
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1235460163
IL
05
1235460163
MO
Enumeration date
01/15/2010
Last updated
04/22/2014
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