Provider Demographics
NPI:1689211823
Name:WANDA EDWARDS
Entity Type:Organization
Organization Name:WANDA EDWARDS
Other - Org Name:HEALTH AND BUSINESS CONSULTANTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER - NURSE PRACTITIONER
Authorized Official - Prefix:DR
Authorized Official - First Name:WANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, RN, PMHNP
Authorized Official - Phone:313-270-4888
Mailing Address - Street 1:14409 ASHTON RD
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48223-3584
Mailing Address - Country:US
Mailing Address - Phone:313-270-4888
Mailing Address - Fax:313-270-4883
Practice Address - Street 1:29000 INKSTER RD STE 115
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1097
Practice Address - Country:US
Practice Address - Phone:313-270-4888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-06
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty