Provider Demographics
NPI:1043077811
Name:EDWARDS, YOLANDA ANTOINETTE (NP)
Entity type:Individual
Prefix:
First Name:YOLANDA
Middle Name:ANTOINETTE
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 1:11240 HIGHWAY 49
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-4151
Mailing Address - Country:US
Mailing Address - Phone:228-831-8800
Mailing Address - Fax:844-886-3945
Practice Address - Street 1:11240 HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-4151
Practice Address - Country:US
Practice Address - Phone:228-831-8800
Practice Address - Fax:844-886-3945
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-28
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS906552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily