FREDRIC EDWARDS (NPI# 1306396015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1306396015 |
| Entity Type | Individual |
| Full Name | FREDRIC EDWARDS |
| Credential | RN |
| Practice Address |
516 E Nizhoni Blvd Gallup NM 87301-5748 |
| Practice Telephone | 5057221790 |
| Mailing Telephone | 5057221790 |
| Enumeration Date | 2016-10-05 |
| Last Update Date | 2016-10-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WC0400X |
Registered Nurse Specialization: Case Management |
725470 | TX | Nursing Service Providers |
| Street Address |
516 E NIZHONI BLVD |
| City | GALLUP |
| State | NM |
| Zip Code | 87301-5748 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326047846 | William Brant Hesidence II | Podiatrist | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2005-07-18 |
| 1205437712 | Maryann T Park | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-11-03 |
| 1649871054 | Lesley J Legah | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-11-03 |
| 1659972073 | Carla B Patterson | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-11-03 |
| 1770183733 | Logan Smolla | Pharmacist | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-29 |
| 1497355499 | Christopher P Sherman | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-28 |
| 1164022414 | Margaret Krick | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-27 |
| 1780283416 | John Robert Sherwood | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-23 |
| 1366041006 | Tracy Michelle Sherwood | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-23 |
| 1306445473 | Stacey Leigh Cortez | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-10-20 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154966141 | Karen Marie Acuesta Arboleda | Registered Nurse | 516 E Nizhoni Bld., Gallup, NM 87301 | 2019-11-13 |
| 1811453707 | Kelly Dahn | Respiratory Therapist, Certified | 516 E Hizhoni Blvd, Gallup, NM 87301 | 2019-02-15 |
| 1417411232 | Frances Griego | Registered Nurse | 28b Alma Drive, Gallup, NM 87301 | 2019-01-25 |
| 1891267605 | Hozho Academy | Occupational Therapist | 306 Nm-564, Gallup, NM 87301 | 2018-12-19 |
| 1922514686 | Jjdac, LLC | Ambulance | 208 W Maloney Ave, Gallup, NM 87301 | 2017-12-18 |
| 1508382698 | Katherine L Kuehl | Pharmacist | Walgreens 1870 E Historic Highway 66, Galliup, NM 87301 | 2017-08-21 |
| 1497285001 | Jessica Kate Savant | Registered Nurse | 516 E Nazhoni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1770013385 | Nicole Aline Pavy | Registered Nurse | 516 E. Nizhioni Blvd, Gallup, NM 87301 | 2017-06-15 |
| 1730612276 | Camie Renee Nelson | Contractor | 121 Bishop Drive, Gallup, NM 87301 | 2017-04-11 |
| 1508216227 | Marriah Silversmith | Technician, Other | 3426 Blue Hill Ave, Gallup, NM 87301 | 2016-06-14 |
| Find all providers in zip 87301 | ||||
| Taxonomy Code | 163WC0400X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Case Management |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144836594 | Jennifer Coleman | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-09-21 |
| 1730728163 | Peggy Laxton | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2020-01-02 |
| 1417594763 | Celestina Ramone | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2019-12-05 |
| 1083185094 | Melissa Kimberly Tsosie | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2018-12-17 |
| 1013486869 | Catherine B Yeomans | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2018-11-21 |
| 1912497843 | Lee Ann Goodluck | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2018-05-16 |
| 1780183889 | Sarah Lenal Whitmore | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2018-02-05 |
| 1275073868 | Jennifer Friedline | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2017-03-01 |
| 1588103923 | Karen Dilorenzo-jones | Registered Nurse | 516 E Nizhoni Blvd, Gallup, NM 87301-5748 | 2017-02-17 |
| 1083161509 | Denice Bobelu | Registered Nurse | 516 Nizhoni Blvd, Gallup, NM 87301 | 2016-09-01 |
| Find all providers in GALLUP | ||||
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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.