Provider Demographics
NPI:1972699148
Name:BYRNE, EDWARD (RNP)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:
Last Name:BYRNE
Suffix:
Gender:M
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14600 SHERMAN WAY
Mailing Address - Street 2:SUITE 220
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-2283
Mailing Address - Country:US
Mailing Address - Phone:818-782-2229
Mailing Address - Fax:818-782-2224
Practice Address - Street 1:14600 SHERMAN WAY
Practice Address - Street 2:SUITE 220
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-2283
Practice Address - Country:US
Practice Address - Phone:818-782-2229
Practice Address - Fax:818-782-2224
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN594604363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner