WANDA E EDWARDS NP NPI 1720086697

NPI Information

NPI: 1720086697
Provider Name: WANDA E EDWARDS, NP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
29000 INKSTER RD
STE 115
SOUTHFIELD, MI
ZIP 48034
Phone: (313) 270-4888
Get Directions

Wanda E Edwards, NP is a psychiatric/mental health nurse practitioner in Southfield, MI. Wanda E Edwards, NP NPI is 1720086697. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

29000 INKSTER RD
STE 115
SOUTHFIELD, MI
ZIP 48034-097
Phone: (313) 270-4888
Fax: (313) 270-4883

The NPI 1720086697 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/13/2005 and was last updated on 12/1/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	163WC1600X	Registered Nurse	Continuing Education/Staff Development	4704102153	MICHIGAN	No
2	163WP0809X	Registered Nurse	Psychiatric/Mental Health, Adult	4704102153	MICHIGAN	No
3	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health	4704102153	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0861058	OTHER	MICHIGAN	BCBS PIN
2	M16694	OTHER	MICHIGAN	MEDICARE - PTAN
3	693558	OTHER	MICHIGAN	VALUE OPTIONS - PROVIDER CONNECT USER ID

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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