Individual
WANDA FAYE EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
5666 LONGBOW DR, STONE MOUNTAIN, GA 30087-5230
(954) 305-1262
Mailing address
5666 LONGBOW DR, STONE MOUNTAIN, GA 30087-5230
(678) 235-8439
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN090419
GA
164W00000X
Licensed Practical Nurse
PN5196378
FL
247000000X
Health Information Technician
—
—
251J00000X
Nursing Care Agency
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
02/21/2018
Last updated
05/05/2020
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