Provider Demographics
NPI:1336613058
Name:EDWARDS, JAMES H III (ACNP)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:H
Last Name:EDWARDS
Suffix:III
Gender:M
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21630 LONGS PEAK LN
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-8311
Mailing Address - Country:US
Mailing Address - Phone:303-668-2357
Mailing Address - Fax:
Practice Address - Street 1:21630 LONGS PEAK LN
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80138-8311
Practice Address - Country:US
Practice Address - Phone:303-668-2357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0994377363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care