Provider Demographics
NPI:1861836025
Name:EDSALL, IOLANDA (MD)
Entity Type:Individual
Prefix:
First Name:IOLANDA
Middle Name:
Last Name:EDSALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:635 INNOVATION DR STE 300
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2215
Mailing Address - Country:US
Mailing Address - Phone:775-329-6241
Mailing Address - Fax:775-329-4921
Practice Address - Street 1:635 INNOVATION DR STE 300
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2215
Practice Address - Country:US
Practice Address - Phone:775-329-6241
Practice Address - Fax:775-329-4921
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV16897207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology