Individual
MARISSA NICOLE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
6711 TOWPATH RD STE 235, EAST SYRACUSE, NY 13057-9509
(315) 471-2646
(315) 471-1762
Mailing address
6711 TOWPATH RD STE 235, EAST SYRACUSE, NY 13057-9509
(315) 471-2646
(315) 471-1762
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
383174
NY
363LP0200X
Pediatric Nurse Practitioner
F383174
NY
363LP0200X
Pediatric Nurse Practitioner
F383174-01
NY
Other
Enumeration date
12/07/2020
Last updated
05/22/2025
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