Provider Demographics
NPI:1619939444
Name:EDWARDS, MARION A (CRNA)
Entity Type:Individual
Prefix:
First Name:MARION
Middle Name:A
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 BISHOP CREEK DR
Mailing Address - Street 2:
Mailing Address - City:SAFETY HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34695-5403
Mailing Address - Country:US
Mailing Address - Phone:727-725-3073
Mailing Address - Fax:
Practice Address - Street 1:38 BISHOP CREEK DR
Practice Address - Street 2:
Practice Address - City:SAFETY HARBOR
Practice Address - State:FL
Practice Address - Zip Code:34695-5403
Practice Address - Country:US
Practice Address - Phone:727-725-3073
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-05
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP577172367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered