Provider Demographics
NPI:1447277041
Name:EDWARDS, DEBORAH LYNNE (RD, LD)
Entity type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:LYNNE
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 PARK ST
Mailing Address - Street 2:
Mailing Address - City:DECORAH
Mailing Address - State:IA
Mailing Address - Zip Code:52101-2034
Mailing Address - Country:US
Mailing Address - Phone:563-382-4676
Mailing Address - Fax:
Practice Address - Street 1:909 W 1ST ST
Practice Address - Street 2:COMMUNITY MEMORIAL HOSPITAL
Practice Address - City:SUMNER
Practice Address - State:IA
Practice Address - Zip Code:50674-1203
Practice Address - Country:US
Practice Address - Phone:563-578-3275
Practice Address - Fax:563-578-3279
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered