Provider Demographics
NPI:1164880829
Name:EDWARDS, BRITTANY IRESHA (CNM, WHNP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:IRESHA
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CNM, WHNP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:IRESHA
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:36065 SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:FORT HOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76544
Mailing Address - Country:US
Mailing Address - Phone:254-288-8000
Mailing Address - Fax:830-315-1366
Practice Address - Street 1:36065 SANTA FE AVE
Practice Address - Street 2:
Practice Address - City:FORT HOOD
Practice Address - State:TX
Practice Address - Zip Code:76544
Practice Address - Country:US
Practice Address - Phone:254-288-8000
Practice Address - Fax:830-315-1366
Is Sole Proprietor?:No
Enumeration Date:2016-02-09
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP130255363LW0102X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX374234801Medicaid