Individual
AMYGRACE EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
825 CLARK STREET, SUITE A, FAIRPLAY, CO 80440-0846
(719) 836-4154
(719) 836-3433
Mailing address
PO BOX 1198, BAILEY, CO 80421-8198
(719) 839-0757
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.1636804
CO
Other
Enumeration date
03/03/2016
Last updated
03/03/2016
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