Provider Demographics
NPI:1255129680
Name:EDWARDS, TIMOTHY AARON JR
Entity type:Individual
Prefix:
First Name:TIMOTHY
Middle Name:AARON
Last Name:EDWARDS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 DARREN CIR
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23701-3103
Mailing Address - Country:US
Mailing Address - Phone:757-510-4876
Mailing Address - Fax:
Practice Address - Street 1:1661 DARREN CIR
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:VA
Practice Address - Zip Code:23701-3103
Practice Address - Country:US
Practice Address - Phone:757-510-4876
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-26
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide