Provider Demographics
NPI:1700669066
Name:EDWARDS, ABENA DANSOA (FNP-C)
Entity Type:Individual
Prefix:
First Name:ABENA
Middle Name:DANSOA
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7100 OAKMONT BLVD STE 105
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-3908
Mailing Address - Country:US
Mailing Address - Phone:817-538-1692
Mailing Address - Fax:
Practice Address - Street 1:7100 OAKMONT BLVD STE 105
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-3908
Practice Address - Country:US
Practice Address - Phone:817-538-1692
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-18
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1115277363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily