Provider Demographics
NPI:1093157166
Name:EDWARDS, ALEXANDRIA PATRICE (RN, MSN, CPNP-PC)
Entity Type:Individual
Prefix:MS
First Name:ALEXANDRIA
Middle Name:PATRICE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RN, MSN, CPNP-PC
Other - Prefix:
Other - First Name:ALEXANDRIA
Other - Middle Name:PATRICE
Other - Last Name:SHIRLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:293 BRADFORD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-3515
Mailing Address - Country:US
Mailing Address - Phone:718-288-2000
Mailing Address - Fax:
Practice Address - Street 1:682 UNION AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-3552
Practice Address - Country:US
Practice Address - Phone:516-571-9500
Practice Address - Fax:516-571-9557
Is Sole Proprietor?:No
Enumeration Date:2013-07-18
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY657910163W00000X
NY382443363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse