Provider Demographics
NPI:1376086439
Name:EDWARDS, LENORR A (RN)
Entity type:Individual
Prefix:
First Name:LENORR
Middle Name:A
Last Name:EDWARDS
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:PO BOX 821435
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE PINES
Mailing Address - State:FL
Mailing Address - Zip Code:33082-1435
Mailing Address - Country:US
Mailing Address - Phone:754-245-4315
Mailing Address - Fax:
Practice Address - Street 1:10228 NW 47TH ST
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33351-7970
Practice Address - Country:US
Practice Address - Phone:754-245-4315
Practice Address - Fax:954-210-7974
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-22
Last Update Date:2016-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9354014163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse