Individual
HOLLY L EDMONDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6400 PERKINS RD, BATON ROUGE, LA 70808-4124
(225) 330-0497
(225) 330-0498
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 765-5727
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
A10599
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6347958
LOUISIANA LICENSE
LA
Enumeration date
02/09/2009
Last updated
01/28/2022
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