Provider Demographics
NPI:1083053193
Name:EDWARDS, LONNA KAY (RN)
Entity Type:Individual
Prefix:MRS
First Name:LONNA
Middle Name:KAY
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:214 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75116-4700
Mailing Address - Country:US
Mailing Address - Phone:972-499-4696
Mailing Address - Fax:972-499-4863
Practice Address - Street 1:214 S MAIN ST
Practice Address - Street 2:
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75116-4700
Practice Address - Country:US
Practice Address - Phone:972-499-4696
Practice Address - Fax:972-499-4863
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No372500000XNursing Service Related ProvidersChore Provider
No372600000XNursing Service Related ProvidersAdult Companion
No374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3747P1801XOtherPERSONAL CARE SERVICES