Provider Demographics
NPI:1235416744
Name:ADAMS, KEVIN (RN, APN)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:ADAMS
Suffix:
Gender:M
Credentials:RN, APN
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 30
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242-0030
Mailing Address - Country:US
Mailing Address - Phone:731-642-0521
Mailing Address - Fax:731-642-1010
Practice Address - Street 1:300 HIGHWAY 641 N
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:TN
Practice Address - Zip Code:38320-3012
Practice Address - Country:US
Practice Address - Phone:731-642-0521
Practice Address - Fax:731-642-1010
Is Sole Proprietor?:No
Enumeration Date:2011-11-11
Last Update Date:2019-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16192364SP0808X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health