Provider Demographics
NPI:1013415843
Name:ADERO, CAROLYNE (FNP)
Entity Type:Individual
Prefix:
First Name:CAROLYNE
Middle Name:
Last Name:ADERO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5510
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85366-2475
Mailing Address - Country:US
Mailing Address - Phone:928-276-4381
Mailing Address - Fax:928-276-9086
Practice Address - Street 1:2189 S AVENUE A STE A
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-8308
Practice Address - Country:US
Practice Address - Phone:928-276-4381
Practice Address - Fax:928-276-4381
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-26
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP10716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily