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MICHAEL B EDENFIELD FNP-C

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1851767214

Individual Registrant:
 MICHAEL B EDENFIELD FNP-C
Gender: M
Sole Proprietor

Location and contact information for practice:
401 W MAIN ST  SWAINSBORO, GA 30401-3110 US
Tel: 478-237-9928  Fax: 478-237-4517

Contact information for business:
PO BOX 1143  SWAINSBORO, GA 30401-1143 US
Tel: 478-494-0331  Fax: --

Registration Information:
NPI: 1851767214
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
GARN198693

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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