Edwards, Petra

Edwards, Petra is an individual health care provider with primary practice located at 3555 Harden Street Ext Ste 141 , Columbia SC 29203-6894. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Edwards, Petra can be contacted via phone (803) 434-4300.

Contact Information

Primary practice address
3555 Harden Street Ext Ste 141 Columbia SC 29203-6894
Phone: (803) 434-4300
Fax: (803) 434-4351
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 19767 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 19767 South Carolina

Profile Details

NPI number 1154791259
LBN Legal business name Edwards, Petra
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 1st, 2015
Last updated Dec 6th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154791259 NPPES
South Carolina MEDICAID NP3459

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