Provider Demographics
NPI:1750831061
Name:EDWARDS, SACHA (NP-C)
Entity Type:Individual
Prefix:
First Name:SACHA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 BELLEVUE LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-3680
Mailing Address - Country:US
Mailing Address - Phone:817-538-9511
Mailing Address - Fax:
Practice Address - Street 1:4532 INTERSTATE 30
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-2028
Practice Address - Country:US
Practice Address - Phone:214-324-8625
Practice Address - Fax:214-324-8644
Is Sole Proprietor?:No
Enumeration Date:2016-10-11
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132402363LA2200X, 363LG0600X
TX791553163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology