MRS. TRACIE THERESA EDWARDS (NPI# 1104486711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1104486711 |
Entity Type | Individual |
Full Name | MRS. TRACIE THERESA EDWARDS |
Credential | NP |
Practice Address |
1412 Milstead Ave Ne Conyers GA 30012-3877 |
Mailing Address |
200 Corporate Blvd Lafayette LA 70508-3870 |
Practice Telephone | 7709183000 |
Practice Fax Number | 7709183104 |
Mailing Telephone | 8008939698 |
Enumeration Date | 2019-06-17 |
Last Update Date | 2019-11-01 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | RN288766 | GA | Physician Assistants & Advanced Practice Nursing Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134384357 | Tracie Dawn Edwards | Hearing Instrument Specialist | 7760 Route 417 W, Bolivar, NY 14715 | 2008-07-28 |
1669084760 | Tracie Susan Edwards | Technician | 4550 W Oakey Blvd Ste 101a, Las Vegas, NV 89102-1506 | 2020-08-19 |
1215439617 | Tracie L Edwards | Case Manager/Care Coordinator | 2500 John Glenn Hwy, Cambridge, OH 43725-9028 | 2018-03-02 |
1821248865 | Tracie R Edwards | Counselor | 1110 Eldon Baker Dr, Flint, MI 48507-1923 | 2008-09-26 |
Street Address |
1412 MILSTEAD AVE NE |
City | CONYERS |
State | GA |
Zip Code | 30012-3877 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1033191093 | Clifford N Grossman | Radiology | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2005-11-16 |
1417570102 | Jonathan Stott | Registered Nurse | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2020-05-28 |
1386116309 | Walker Lake Intensivist, PC | Physician Assistant | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2019-01-02 |
1437629342 | Walker Lake Emergency Group, PC | Physician Assistant | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2018-12-04 |
1003385964 | Walker Lake Physician Services, PC | Internal Medicine | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2018-11-20 |
1104328095 | Enas Basha | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2018-03-06 |
1306355680 | Piedmont Rockdale Hospital Inc. | General Acute Care Hospital | 1412 Milstead Ave Ne, Conyers, GA 30012 | 2017-09-29 |
1093254658 | Taylor Zahn Yengst | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2017-02-15 |
1285186452 | Shadae Mcmillan | Podiatrist | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2016-11-03 |
1528414943 | Kimberly Anderson | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2016-05-05 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578188306 | The Eye Md | Ophthalmology | 1359 Milstead Road, Suite #103, Conyers, GA 30012 | 2020-06-08 |
1043855836 | Maurvet Minto | Counselor | 1175 Green St, Conyers, Conyers, GA 30012 | 2019-11-15 |
1770054561 | Sarah Elizabeth Brooks | Physical Medicine & Rehabilitation | 1290 Milstead Ave Ne, Conyers, GA 30012 | 2018-12-06 |
1679091276 | Valorie Antoinette Jones | Counselor | 1175 Green St Se, Conyers, GA 30012 | 2017-09-02 |
1558886341 | Synergy Radiology, LLC | Radiology | 1501 Milstead Road, Suite 140, Conyers, GA 30012 | 2017-08-14 |
1558813295 | Salon Lyon, LLC | Specialist | 1112 West Ave, Se, B, Conyers, GA 30012 | 2016-10-28 |
1992252753 | Traci Hunter Bryan | Pharmacist | 1501 Milstead Ave Ne, Suite 110, Conyers, GA 30012 | 2016-09-08 |
1316491830 | Hye Rim Kim | Anesthesiologist Assistant | 1380 Milstead Rd Ne, Suite G, Conyers, GA 30012 | 2016-08-12 |
1235591397 | David Jeffrey Wasserman | Optometrist | 1192 Dogwood Dr Sw, Conyers, GA 30012 | 2016-03-28 |
1174919187 | Anique Archer | Health Educator | 2170 Lester Rd Nw, Conyers, GA 30012 | 2015-04-07 |
Find all providers in zip 30012 |
Taxonomy Code | 363L00000X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104438530 | Mwiche Williams | Nurse Practitioner | 2337 Deerfield Chase Se, Conyers, GA 30013-6307 | 2020-08-18 |
1144790973 | Marlyn M. Wallace | Nurse Practitioner | 3073 Klondike Rd Sw, Conyers, GA 30094-5660 | 2018-12-05 |
1174979587 | Taaliba Al-alim Sahib Jr. | Nurse Practitioner | 511 Greenleaf Rd, Conyers, GA 30013-2274 | 2016-05-05 |
1679962534 | Rose Gayle-smith | Nurse Practitioner | 2081 Millstone Dr Sw, Conyers, GA 30094-3981 | 2015-01-15 |
1124363577 | Terri Tonisha Van Dorn | Nurse Practitioner | 1901 Honey Creek Commons Se, Conyers, GA 30013-5806 | 2012-12-11 |
1700908688 | Angela L. Bright | Nurse Practitioner | 1157 West Ave Sw # B, Conyers, GA 30012-5280 | 2007-04-04 |
1881259703 | Desiree Riley | Nurse Practitioner | 1388 Wellbrook Cir Ne Ste A, Conyers, GA 30012-3872 | 2019-05-06 |
1528550068 | Chinyere Chigbu | Nurse Practitioner | 1501 Milstead Rd Ne Ste 110, Conyers, GA 30012-3849 | 2018-05-31 |
1093254658 | Taylor Zahn Yengst | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2017-02-15 |
1528414943 | Kimberly Anderson | Nurse Practitioner | 1412 Milstead Ave Ne, Conyers, GA 30012-3877 | 2016-05-05 |
Find all providers in CONYERS |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.