Provider Demographics
NPI:1134590029
Name:EDWARDS, NICOLE (CD(DONA))
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7270 KRAMERIA ST
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-1926
Mailing Address - Country:US
Mailing Address - Phone:720-841-9123
Mailing Address - Fax:
Practice Address - Street 1:7270 KRAMERIA ST
Practice Address - Street 2:
Practice Address - City:COMMERCE CITY
Practice Address - State:CO
Practice Address - Zip Code:80022-1926
Practice Address - Country:US
Practice Address - Phone:720-841-9123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-17
Last Update Date:2015-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10038374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula