Individual
TRISEANA EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14415 BRISTOL AVE, GRANDVIEW, MO 64030-4103
(816) 585-7657
Mailing address
14415 BRISTOL AVE, GRANDVIEW, MO 64030-4103
(816) 585-7657
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
20-0298R25
MO
174200000X
Meals Provider
Primary
—
—
246RP1900X
Phlebotomy Technician
20-0298R25
—
Other
Enumeration date
02/22/2024
Last updated
12/02/2025
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