Basic Information
| Provider Information | |||||||||
| NPI: | 1023356425 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EDWARDS | ||||||||
| FirstName: | EMMA | ||||||||
| MiddleName: | SAMEERA | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 7121 STEPHANIE LN STE 102 | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685165352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9706632742 | ||||||||
| FaxNumber: | 9703422093 | ||||||||
| Practice Location | |||||||||
| Address1: | 7121 STEPHANIE LN STE 102 | ||||||||
| Address2: | |||||||||
| City: | LINCOLN | ||||||||
| State: | NE | ||||||||
| PostalCode: | 685165352 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4024135010 | ||||||||
| FaxNumber: | 4024135009 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/21/2013 | ||||||||
| LastUpdateDate: | 03/24/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/24/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 1694 | NE | N | Allopathic & Osteopathic Physicians | Family Medicine | 363AM0700X | 1694 | NE | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.