Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | ARNP9212580 | FL |
NPI | 1912980673 |
---|---|
Provider Name | Baipidi Emily Edwards |
First Address | Bartow, FL 33830 |
Second Address | Haines City, FL 33844-8839 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/11/2005 |
Last Update Date | 27/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
306121300 | (05) | FL |
Q14800 | (02) |