Provider Demographics
NPI:1326766247
Name:EDWARDS, LATOYA JANICE (NP-C)
Entity Type:Individual
Prefix:MS
First Name:LATOYA
Middle Name:JANICE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7691 CABRINI PL
Mailing Address - Street 2:
Mailing Address - City:FAIRBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30213-5521
Mailing Address - Country:US
Mailing Address - Phone:313-600-7079
Mailing Address - Fax:
Practice Address - Street 1:837 LEE ST SW STE C
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30310-2745
Practice Address - Country:US
Practice Address - Phone:786-831-4348
Practice Address - Fax:302-216-1989
Is Sole Proprietor?:No
Enumeration Date:2022-08-17
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF07200441363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily