Individual
STEPHANIE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
1120 E MAIN ST STE 24, PHILADELPHIA, MS 39350-2300
(601) 781-8677
Mailing address
6880 COBBLESTONE BLVD, STE 2, SOUTHAVEN, MS 38672-9313
(662) 638-3757
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
866510
MS
Other
Enumeration date
01/04/2018
Last updated
04/23/2019
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