Provider Demographics
NPI:1205346087
Name:EDWARDS, ANNA C (CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:ANNA
Middle Name:C
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 S COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-3303
Mailing Address - Country:US
Mailing Address - Phone:303-369-1077
Mailing Address - Fax:303-369-9785
Practice Address - Street 1:1325 S COLORADO BLVD
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-3303
Practice Address - Country:US
Practice Address - Phone:303-369-1077
Practice Address - Fax:303-369-9785
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-05
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0993576363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO0993576Medicaid