Provider Demographics
NPI:1053569376
Name:EDWARDS, DAPHNE C (RN, CPNP)
Entity type:Individual
Prefix:MRS
First Name:DAPHNE
Middle Name:C
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10221 KRAUSE RD UNIT 1262
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832-1250
Mailing Address - Country:US
Mailing Address - Phone:804-803-3334
Mailing Address - Fax:804-803-3334
Practice Address - Street 1:2493 BOULEVARD
Practice Address - Street 2:
Practice Address - City:COLONIAL HEIGHTS
Practice Address - State:VA
Practice Address - Zip Code:23834-2317
Practice Address - Country:US
Practice Address - Phone:804-504-5490
Practice Address - Fax:833-989-0990
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-28
Last Update Date:2025-01-06
Deactivation Date:2023-03-17
Deactivation Code:
Reactivation Date:2023-03-30
Provider Licenses
StateLicense IDTaxonomies
VA001119792163W00000X
VA0024164386363LP0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics