Provider Demographics
NPI:1912757022
Name:EDWARDS-HEDBERG, ANGEL (RN)
Entity Type:Individual
Prefix:
First Name:ANGEL
Middle Name:
Last Name:EDWARDS-HEDBERG
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 1:162 WILSON DR
Mailing Address - Street 2:
Mailing Address - City:WORTHINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43085-4050
Mailing Address - Country:US
Mailing Address - Phone:614-886-5687
Mailing Address - Fax:
Practice Address - Street 1:700 ACKERMAN RD STE 6100
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43202-1559
Practice Address - Country:US
Practice Address - Phone:614-685-5395
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-25
Last Update Date:2024-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH316832163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse