Provider Demographics
NPI:1346507647
Name:EDWARDS, JAMES RICHARD (RN)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:RICHARD
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3599 UNIVERSITY BLVD S
Mailing Address - Street 2:BROOKS REHABILITATION HOSPITAL
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-4259
Mailing Address - Country:US
Mailing Address - Phone:904-345-7625
Mailing Address - Fax:
Practice Address - Street 1:3599 UNIVERSITY BLVD S
Practice Address - Street 2:BROOKS REHABILITATION HOSPITAL
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-4259
Practice Address - Country:US
Practice Address - Phone:904-345-7625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-12
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1559152163WA2000X, 163WC0400X, 163WR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation