Provider Demographics
NPI:1669195319
Name:GARBER, EDWINA LYNN (RN)
Entity type:Individual
Prefix:MRS
First Name:EDWINA
Middle Name:LYNN
Last Name:GARBER
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 1:2404 BUFFALO MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:ARBOVALE
Mailing Address - State:WV
Mailing Address - Zip Code:24915-5423
Mailing Address - Country:US
Mailing Address - Phone:304-642-4144
Mailing Address - Fax:
Practice Address - Street 1:2404 BUFFALO MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:ARBOVALE
Practice Address - State:WV
Practice Address - Zip Code:24915-5423
Practice Address - Country:US
Practice Address - Phone:304-642-4144
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-19
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV49284163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse