Provider Demographics
NPI:1215568993
Name:EDWARDS, LASHAWNA (CNA)
Entity Type:Individual
Prefix:
First Name:LASHAWNA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 FULTON ST
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32114-3518
Mailing Address - Country:US
Mailing Address - Phone:386-451-7843
Mailing Address - Fax:
Practice Address - Street 1:244 FULTON ST
Practice Address - Street 2:
Practice Address - City:DAYTONA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32114-3518
Practice Address - Country:US
Practice Address - Phone:386-451-7843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2020-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL84787376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL000000000OtherCNA