Provider Demographics
NPI:1477164028
Name:EDWARDS, CORRINNA MONIQUE (CPM)
Entity type:Individual
Prefix:
First Name:CORRINNA
Middle Name:MONIQUE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10375 WORTHINGTON HILLS MNR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1725
Mailing Address - Country:US
Mailing Address - Phone:404-805-2059
Mailing Address - Fax:
Practice Address - Street 1:10375 WORTHINGTON HILLS MNR
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1725
Practice Address - Country:US
Practice Address - Phone:404-805-2059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife