Provider Demographics
NPI:1457058372
Name:EDWARDS, DEBBIAN CARLENE (RN)
Entity Type:Individual
Prefix:
First Name:DEBBIAN
Middle Name:CARLENE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 E GUN HILL RD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-6016
Mailing Address - Country:US
Mailing Address - Phone:718-944-3189
Mailing Address - Fax:718-379-0244
Practice Address - Street 1:2000 E GUN HILL RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-6016
Practice Address - Country:US
Practice Address - Phone:718-944-3189
Practice Address - Fax:718-379-0244
Is Sole Proprietor?:No
Enumeration Date:2023-02-10
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY856219-01163W00000X
NY856219163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse