Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0005X | Nurse Practitioner - Neonatal (Critical Care) | SP011139 | PA |
NPI | 1225331176 |
---|---|
Provider Name | Taryn Marie Edwards |
First Address | Wilmington, DE 19804-2354 |
Second Address | Wilmington, DE 19804-2354 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2010 |
Last Update Date | 15/12/2010 |