Provider Demographics
NPI:1801299243
Name:EDWARDS, LOIS OLUKEMI (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LOIS
Middle Name:OLUKEMI
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 RED MILLS RD
Mailing Address - Street 2:
Mailing Address - City:WALLKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12589-3220
Mailing Address - Country:US
Mailing Address - Phone:845-744-9105
Mailing Address - Fax:
Practice Address - Street 1:800 RED MILLS RD
Practice Address - Street 2:
Practice Address - City:WALLKILL
Practice Address - State:NY
Practice Address - Zip Code:12589-3220
Practice Address - Country:US
Practice Address - Phone:845-744-9105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-30
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF338507363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily