| NPI | 1578003554 |
|---|---|
| Former Name | ELYSE EDWARDS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024174567) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024174567) |
| Enumeration Date | 2017-02-24 |
| Last Update Date | 2021-08-11 |