Provider Demographics
NPI:1053044719
Name:EDWARDS, CARLEY (CRNP)
Entity Type:Individual
Prefix:
First Name:CARLEY
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:96 OBSERVATORY ST
Mailing Address - Street 2:
Mailing Address - City:MANOR
Mailing Address - State:PA
Mailing Address - Zip Code:15665-9602
Mailing Address - Country:US
Mailing Address - Phone:724-875-5177
Mailing Address - Fax:
Practice Address - Street 1:5426 MIFFLIN RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15207-2350
Practice Address - Country:US
Practice Address - Phone:412-462-1800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-08
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026842363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily