Basic Information
| Provider Information | |||||||||
| NPI: | 1558573402 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EDMONDSON | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | V. | ||||||||
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| Credential: | RN, CNM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6285 BARFIELD RD NE | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303284303 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4043031224 | ||||||||
| FaxNumber: | 4043031325 | ||||||||
| Practice Location | |||||||||
| Address1: | 11975 MORRIS RD | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | ALPHARETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300054419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7705212295 | ||||||||
| FaxNumber: | 7702550333 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/04/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 176B00000X | RN042227 | GA | Y | Other Service Providers | Midwife |
No ID Information.