Provider Demographics
NPI:1568909570
Name:EDMOND, VERNICIA A (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:VERNICIA
Middle Name:A
Last Name:EDMOND
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:VERNICIA
Other - Middle Name:A
Other - Last Name:VALENTIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSN, FNP-BC, CPN
Mailing Address - Street 1:16701 MELFORD BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20715-4411
Mailing Address - Country:US
Mailing Address - Phone:877-560-3792
Mailing Address - Fax:
Practice Address - Street 1:16701 MELFORD BLVD
Practice Address - Street 2:STE 400
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20715-4411
Practice Address - Country:US
Practice Address - Phone:877-560-3792
Practice Address - Fax:877-560-3792
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-28
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCRN1014617363LF0000X
MDR182544363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily