Individual
EDWARD LEE PEARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NURSE PRACTITIONER
Contact information
Practice address
320 HUBBARD ST, SAINT LOUIS, MI 48880-1926
(989) 681-6668
Mailing address
363 EDEN ST, KINGSLEY, MI 49649-9289
(231) 620-5408
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
4704206310
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704206310
NURSE PRACTITIONER SPECIALTY CERTIFICATION
MI
Enumeration date
05/03/2018
Last updated
06/16/2018
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