Provider Demographics
NPI:1841659497
Name:EDWARDS, MARINA (BSN, RN)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:MARINA
Other - Middle Name:ANNE
Other - Last Name:WALTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSN, RN
Mailing Address - Street 1:334 RED HAVEN CT
Mailing Address - Street 2:
Mailing Address - City:JOPPA
Mailing Address - State:MD
Mailing Address - Zip Code:21085-5413
Mailing Address - Country:US
Mailing Address - Phone:301-606-5794
Mailing Address - Fax:814-734-1700
Practice Address - Street 1:448 ERIE ST
Practice Address - Street 2:SUITE 200
Practice Address - City:EDINBORO
Practice Address - State:PA
Practice Address - Zip Code:16412-2294
Practice Address - Country:US
Practice Address - Phone:814-734-1499
Practice Address - Fax:814-734-1700
Is Sole Proprietor?:No
Enumeration Date:2016-02-10
Last Update Date:2016-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR169506163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management