| Edwards Premier Healthcare Llc | |
|
1201 North Main Avenue Erwin TN 37650 | |
| (423) 220-0625 | |
| Not Available |
| Full Name | Edwards Premier Healthcare Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1201 North Main Avenue, Erwin, Tennessee |
| Authorized Official Name and Position | Katrina Edwards (OWNER) |
| Authorized Official Contact | 4232200625 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Edwards Premier Healthcare Llc 1201 North Main Avenue Erwin TN 37650 Ph: (423) 220-0625 | Edwards Premier Healthcare Llc 1201 North Main Avenue Erwin TN 37650 Ph: (423) 220-0625 |
| NPI Number | 1730725706 |
|---|---|
| Provider Enumeration Date | 11/25/2019 |
| Last Update Date | 11/25/2019 |
| Medicare PECOS PAC ID | 3476983545 |
|---|---|
| Medicare Enrollment ID | O20200414002162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730725706 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Katrina D Edwards |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922519693 PECOS PAC ID: 9638438567 Enrollment ID: I20180122001477 |
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