Provider Demographics
NPI:1871349969
Name:EDWARDS, AUBREY MERCER (RDN)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:MERCER
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:
Other - Last Name:MERCER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:80 S MAIN ST APT 5
Mailing Address - Street 2:
Mailing Address - City:NORTH SALT LAKE
Mailing Address - State:UT
Mailing Address - Zip Code:84054-2597
Mailing Address - Country:US
Mailing Address - Phone:801-940-3118
Mailing Address - Fax:
Practice Address - Street 1:80 S MAIN ST APT 5
Practice Address - Street 2:
Practice Address - City:NORTH SALT LAKE
Practice Address - State:UT
Practice Address - Zip Code:84054-2597
Practice Address - Country:US
Practice Address - Phone:801-940-3118
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2025-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14234044-4901133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered