Provider Demographics
NPI:1548533235
Name:EDWARDS, VANESSA SHENEE (RPA-C)
Entity type:Individual
Prefix:
First Name:VANESSA
Middle Name:SHENEE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2601 OCEAN PKWY
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11235-7745
Mailing Address - Country:US
Mailing Address - Phone:718-616-3880
Mailing Address - Fax:718-616-4156
Practice Address - Street 1:2601 OCEAN PKWY
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235-7745
Practice Address - Country:US
Practice Address - Phone:718-616-3880
Practice Address - Fax:718-616-4156
Is Sole Proprietor?:No
Enumeration Date:2012-02-11
Last Update Date:2015-05-04
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant