Provider Demographics
NPI:1043016934
Name:EDWARDS, SHANICE N (NP)
Entity type:Individual
Prefix:MRS
First Name:SHANICE
Middle Name:N
Last Name:EDWARDS
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1449 RIVERS EDGE TRCE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23323-5751
Mailing Address - Country:US
Mailing Address - Phone:619-608-0826
Mailing Address - Fax:
Practice Address - Street 1:1449 RIVERS EDGE TRCE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23323-5751
Practice Address - Country:US
Practice Address - Phone:619-608-0826
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program