Provider Demographics
NPI:1447485008
Name:EDWARDS, ASHLEY JO (BSN, RN)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:JO
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4846 DEL MONTE AVE
Mailing Address - Street 2:APT. #2
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92107-3220
Mailing Address - Country:US
Mailing Address - Phone:919-360-9217
Mailing Address - Fax:
Practice Address - Street 1:3851 ROSECRANS ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92110-3134
Practice Address - Country:US
Practice Address - Phone:619-692-5742
Practice Address - Fax:619-692-5650
Is Sole Proprietor?:No
Enumeration Date:2009-05-26
Last Update Date:2009-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA708670163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse