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Individual

PAMELA EDGEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
501 MIZE ST, LA FAYETTE, GA 30728-3346
(706) 806-1222
Mailing address
501 MIZE ST, LA FAYETTE, GA 30728-3346

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
072205
GA

Other

Enumeration date
12/17/2014
Last updated
12/17/2014
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