Individual
MISTY EDWARDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1655 SUNSET DR, GRENADA, MS 38901-4061
(662) 226-6550
Mailing address
481 BROADFIELD DR, GRENADA, MS 38901-7832
(662) 809-0760
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-09460
MS
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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