Provider Demographics
NPI:1649489386
Name:EDLUND, BARBARA JANE (RN, PHD, ANP, BC)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:JANE
Last Name:EDLUND
Suffix:
Gender:F
Credentials:RN, PHD, ANP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:99 JONATHAN LUCAS ST
Mailing Address - Street 2:P.O BOX 250160
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29425-8900
Mailing Address - Country:US
Mailing Address - Phone:843-792-4653
Mailing Address - Fax:843-792-2104
Practice Address - Street 1:99 JONATHAN LUCAS ST
Practice Address - Street 2:COLLEGE OF NURSING
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29425-8900
Practice Address - Country:US
Practice Address - Phone:843-792-4653
Practice Address - Fax:843-792-2104
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCAPN115363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner