Provider Demographics
NPI:1184965220
Name:EDWARDS, FREDA ELIZABETH
Entity type:Individual
Prefix:MRS
First Name:FREDA
Middle Name:ELIZABETH
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:590 CALDWELL AVE
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44905-1401
Mailing Address - Country:US
Mailing Address - Phone:419-989-3980
Mailing Address - Fax:
Practice Address - Street 1:590 CALDWELL AVE
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44905-1401
Practice Address - Country:US
Practice Address - Phone:419-989-3980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-14
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No347C00000XTransportation ServicesPrivate Vehicle
No376K00000XNursing Service Related ProvidersNurse's Aide
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)