Individual
ELOIS EDGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
401 S MADISON ST, ALBANY, GA 31701-3111
(229) 888-3636
Mailing address
204 N WESTOVER BLVD, ALBANY, GA 31707-2983
(229) 888-6559
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
RNO54422
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00838065A
—
GA
Enumeration date
11/10/2006
Last updated
11/28/2011
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