Individual
STEFANIE EDGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN, CWON
Contact information
Practice address
3181 SHORE DR, VIRGINIA BEACH, VA 23451-1129
(757) 496-1653
Mailing address
3181 SHORE DR, VIRGINIA BEACH, VA 23451-1129
(703) 863-4436
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
0001296945
VA
163WX1500X
Ostomy Care Registered Nurse
0001296945
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2005469144
WOCNCB
—
Enumeration date
10/15/2024
Last updated
10/15/2024
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