Provider Demographics
NPI:1053576637
Name:EDWARDS, PATRICIA GUIN (OPTICIAN)
Entity type:Individual
Prefix:MISS
First Name:PATRICIA
Middle Name:GUIN
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 GASKINS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-4919
Mailing Address - Country:US
Mailing Address - Phone:804-741-4218
Mailing Address - Fax:
Practice Address - Street 1:1336 GASKINS RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-4919
Practice Address - Country:US
Practice Address - Phone:804-741-4218
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1101 001595156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician