Provider Demographics
NPI:1003509654
Name:ADAMS, CHARLOTTE (APRN)
Entity Type:Individual
Prefix:
First Name:CHARLOTTE
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 ELM TREE LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40507-2117
Mailing Address - Country:US
Mailing Address - Phone:859-257-8801
Mailing Address - Fax:859-257-2828
Practice Address - Street 1:217 ELM TREE LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-2117
Practice Address - Country:US
Practice Address - Phone:859-257-8801
Practice Address - Fax:859-257-2828
Is Sole Proprietor?:No
Enumeration Date:2023-05-31
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KY4006184363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program