Individual
ETHEL EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
401 IROQUOIS TRL, SHREVEPORT, LA 71107-5419
(318) 936-1796
Mailing address
401 IROQUOIS TRL, SHREVEPORT, LA 71107-5419
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
04/19/2022
Last updated
04/19/2022
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