Provider Demographics
NPI:1912649237
Name:EDWARDS, JARRETT MATTHEW (APRN, CNS)
Entity Type:Individual
Prefix:DR
First Name:JARRETT
Middle Name:MATTHEW
Last Name:EDWARDS
Suffix:
Gender:M
Credentials:APRN, CNS
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:4505 KOLOHALA ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-4940
Mailing Address - Country:US
Mailing Address - Phone:210-602-8256
Mailing Address - Fax:
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:
Practice Address - City:TRIPLER ARMY MEDICAL CENTER
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-3050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-07
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP140560364SA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2100XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAcute Care