Provider Demographics
NPI:1851356877
Name:EDWARDS, BETH VIRGINIA (PA-C)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:VIRGINIA
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1530 N LIMESTONE ST
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29340-4742
Mailing Address - Country:US
Mailing Address - Phone:864-216-4640
Mailing Address - Fax:
Practice Address - Street 1:1530 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-4742
Practice Address - Country:US
Practice Address - Phone:864-216-4640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2014-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant