Individual
MRS. CRYSTAL EDWARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
125 S MAIN ST STE A, BLADENBORO, NC 28320-8440
(910) 809-0030
Mailing address
PO BOX 88, BLADENBORO, NC 28320-0088
(910) 809-0030
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
103768
NC
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02703
BCBS
NC
05
—
8941520
—
NC
Enumeration date
10/28/2005
Last updated
06/13/2024
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