Provider Demographics
NPI:1265506059
Name:ADKINS, GLORIA CAROLYN
Entity Type:Individual
Prefix:MRS
First Name:GLORIA
Middle Name:CAROLYN
Last Name:ADKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36304 KENAI SPUR HWY
Mailing Address - Street 2:
Mailing Address - City:SOLDOTNA
Mailing Address - State:AK
Mailing Address - Zip Code:99669
Mailing Address - Country:US
Mailing Address - Phone:907-260-5840
Mailing Address - Fax:907-260-1996
Practice Address - Street 1:36304 KENAI SPUR HWY
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669
Practice Address - Country:US
Practice Address - Phone:907-260-5840
Practice Address - Fax:907-260-1996
Is Sole Proprietor?:No
Enumeration Date:2006-11-20
Last Update Date:2013-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK367111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK153431Medicare PIN