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Individual

CHARMAIN ELIZABETH EDWARDS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
6100 ROSECREST DR, DAYTON, OH 45414
(937) 898-6219
Mailing address
6100 ROSECREST DR, DAYTON, OH 45414-2831
(937) 898-6219

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 133154
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2895934
OH
01
PN 133154
LPN
OH
Enumeration date
02/10/2009
Last updated
07/22/2009
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