Provider Demographics
NPI:1477535359
Name:EDWARDS, JEAN M (ARNP)
Entity Type:Individual
Prefix:PROF
First Name:JEAN
Middle Name:M
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6575 RAMROD RD
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80922-3059
Mailing Address - Country:US
Mailing Address - Phone:719-637-0839
Mailing Address - Fax:
Practice Address - Street 1:BUILDING 1041, TMC 9
Practice Address - Street 2:EVANS ARMY COMMUNITY HOSPITAL
Practice Address - City:FT CARSON
Practice Address - State:CO
Practice Address - Zip Code:80913
Practice Address - Country:US
Practice Address - Phone:719-524-2003
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP3113392163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse