National Provider Identifier

Fantazia M Edick, LPN

Fantazia M Edick, LPN is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Rochester, NY and a listed phone number of (585) 478-0048.

NPI 1174875082Rochester, NYLicensed Practical Nurse

Profile Overview

NPI
1174875082
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
October 03, 2012
Last Updated
October 03, 2012

Practice Location

  • 614 Clay Ave
  • 2
  • Rochester, NY 14613-1030

Phone: (585) 478-0048

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1174875082
Entity Type
Individual
Last Name
Edick
First Name
Fantazia
Middle Name
M
Credential
LPN
Mailing Street Address
614 Clay Ave
Mailing Address Line 2
2
Mailing City
Rochester
Mailing State
NY
Mailing ZIP Code
14613-1030
Mailing Country
US
Mailing Phone
(585) 478-0048
Practice Street Address
614 Clay Ave
Practice Address Line 2
2
Practice City
Rochester
Practice State
NY
Practice ZIP Code
14613-1030
Practice Country
US
Practice Phone
(585) 478-0048
Enumeration Date
October 03, 2012
Last Updated
October 03, 2012
Sex
Female
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)