Provider Demographics
NPI:1053676338
Name:EDWARDS, MICHELLE ANGELA (RN, BSN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ANGELA
Last Name:EDWARDS
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5306 CLIMBER CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77041-5504
Mailing Address - Country:US
Mailing Address - Phone:281-546-5580
Mailing Address - Fax:832-328-7663
Practice Address - Street 1:5306 CLIMBER CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-5504
Practice Address - Country:US
Practice Address - Phone:281-546-5580
Practice Address - Fax:832-328-7663
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2012-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX584169163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse