Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | 646117 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 646117 | TX |
NPI | 1033280342 |
---|---|
Provider Name | Dr. Michelle L Edwards |
First Address | League City, TX 77574-0714 |
Second Address | Houston, TX 77074-2012 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2006 |
Last Update Date | 17/09/2013 |