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Individual

MICHELLE BLALOCK EDGEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNM

Contact information

Practice address
1105 BURLEYSON RD, DALTON, GA 30720-3181
(706) 278-4640
(706) 275-6599
Mailing address
1105 BURLEYSON RD, DALTON, GA 30720-3181
(706) 278-4640
(706) 275-6599

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
RN135120
GA
367A00000X
Advanced Practice Midwife
Primary
RN135120
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
472966726A
GA
Enumeration date
11/14/2008
Last updated
10/12/2011
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