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Individual

MR. JARED DANIEL EDMONDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PMHNP

Contact information

Practice address
3205 RANDALL PKWY STE 105, WILMINGTON, NC 28403-2565
(910) 742-9243
Mailing address
1012 JUSTUS DR, JOHNSON CITY, TN 37604-6300

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
245445
NC
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
5021554
NC

Other

Enumeration date
01/09/2025
Last updated
02/06/2025
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