Provider Demographics
NPI:1922816016
Name:EDWARDS, ANA (PHARMD)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:
Last Name:EDWARDS
Suffix:
Gender:U
Credentials:PHARMD
Other - Prefix:
Other - First Name:ANA
Other - Middle Name:
Other - Last Name:OVALLE EDWARDS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:150 N SONOMA RANCH BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-1608
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:150 N SONOMA RANCH BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-1608
Practice Address - Country:US
Practice Address - Phone:575-323-6097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-20
Last Update Date:2024-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRP00010267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist