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Individual

TAJUANA CHANTELL EDWARDS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
100 JOHN DANTIS RD SW, ALBUQUERQUE, NM 87151-0100
(505) 417-1416
Mailing address
700 8TH AVE W, STE 101, PALMETTO, FL 34221-4737
(941) 776-4000
(941) 845-4963

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
11016252
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
72615
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP61363319
WA

Other

Enumeration date
10/27/2021
Last updated
02/09/2026
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