Provider Demographics
NPI:1083092357
Name:FIELDS, ADRIENNE N (NP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:N
Last Name:FIELDS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1940 CARSWELL AVE BLDG 7002
Mailing Address - Street 2:
Mailing Address - City:JBSA LACKLAND
Mailing Address - State:TX
Mailing Address - Zip Code:78236-5514
Mailing Address - Country:US
Mailing Address - Phone:210-292-1044
Mailing Address - Fax:
Practice Address - Street 1:1940 CARSWELL AVE BLDG 7002
Practice Address - Street 2:
Practice Address - City:JBSA LACKLAND
Practice Address - State:TX
Practice Address - Zip Code:78236-5514
Practice Address - Country:US
Practice Address - Phone:210-292-1044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-07
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP126627363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care