Provider Demographics
NPI:1649420647
Name:EDWARDS, NADYA (FNP)
Entity Type:Individual
Prefix:
First Name:NADYA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10565 N. TATUM
Mailing Address - Street 2:SUITE B-116
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253
Mailing Address - Country:US
Mailing Address - Phone:480-991-3203
Mailing Address - Fax:480-991-3997
Practice Address - Street 1:10565 N TATUM BLVD
Practice Address - Street 2:SUITE B-116
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-1095
Practice Address - Country:US
Practice Address - Phone:480-991-3203
Practice Address - Fax:480-991-3997
Is Sole Proprietor?:No
Enumeration Date:2008-09-25
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN114597363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1649420647Medicare PIN