Provider Demographics
NPI:1861901977
Name:EDWARDS, JULIE ANN (FNP)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:ANN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1665 N SR 257
Mailing Address - Street 2:
Mailing Address - City:OTWELL
Mailing Address - State:IN
Mailing Address - Zip Code:47564
Mailing Address - Country:US
Mailing Address - Phone:812-354-1020
Mailing Address - Fax:812-354-1025
Practice Address - Street 1:1665 N. SR 257
Practice Address - Street 2:
Practice Address - City:OTWELL
Practice Address - State:IN
Practice Address - Zip Code:47564
Practice Address - Country:US
Practice Address - Phone:812-354-1020
Practice Address - Fax:812-354-1025
Is Sole Proprietor?:No
Enumeration Date:2017-09-21
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28125764A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily