Provider Demographics
NPI:1437462272
Name:EDGEWORTH, NANCY ANN (PHARMD, CDE)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:ANN
Last Name:EDGEWORTH
Suffix:
Gender:F
Credentials:PHARMD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 BROADVIEW DR
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MD
Mailing Address - Zip Code:21613-3562
Mailing Address - Country:US
Mailing Address - Phone:410-221-1858
Mailing Address - Fax:
Practice Address - Street 1:1318 BROADVIEW DR
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MD
Practice Address - Zip Code:21613-3562
Practice Address - Country:US
Practice Address - Phone:410-221-1858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-21
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD142191835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist