Provider Demographics
NPI:1740730845
Name:EDWARDS, LARVAR TAMIKA (LPN)
Entity type:Individual
Prefix:MRS
First Name:LARVAR
Middle Name:TAMIKA
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4039 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:TRAINER
Mailing Address - State:PA
Mailing Address - Zip Code:19061-5003
Mailing Address - Country:US
Mailing Address - Phone:484-390-9379
Mailing Address - Fax:610-494-5810
Practice Address - Street 1:4039 W 7TH ST
Practice Address - Street 2:
Practice Address - City:TRAINER
Practice Address - State:PA
Practice Address - Zip Code:19061-5003
Practice Address - Country:US
Practice Address - Phone:484-390-9379
Practice Address - Fax:610-494-5810
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-12
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA30273601253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA30273601OtherHEAVENLY HANDS OF NURSING LLC
PA30273601OtherNON-MEDICAL HOMECARE