Provider Demographics
NPI:1376043034
Name:EDWARDS, JERRI STONE (APRN, FNP, PMHNP)
Entity Type:Individual
Prefix:
First Name:JERRI
Middle Name:STONE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:APRN, FNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2634 CAPITAL CIR NE
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32308-4106
Mailing Address - Country:US
Mailing Address - Phone:850-523-3333
Mailing Address - Fax:
Practice Address - Street 1:2634 CAPITAL CIR NE
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4106
Practice Address - Country:US
Practice Address - Phone:850-523-3333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-19
Last Update Date:2024-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9350944163WC1500X
FL11014211363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily