Provider Demographics
NPI:1356857825
Name:RODDY, ADRIANNE CLAIRE JOANNE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANNE
Middle Name:CLAIRE JOANNE
Last Name:RODDY
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:MS
Other - First Name:ADRIANNE
Other - Middle Name:CLAIRE JOANNE
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:211 E 2ND ST
Mailing Address - Street 2:
Mailing Address - City:LIBBY
Mailing Address - State:MT
Mailing Address - Zip Code:59923-2047
Mailing Address - Country:US
Mailing Address - Phone:406-293-8711
Mailing Address - Fax:
Practice Address - Street 1:211 E 2ND ST
Practice Address - Street 2:
Practice Address - City:LIBBY
Practice Address - State:MT
Practice Address - Zip Code:59923-2047
Practice Address - Country:US
Practice Address - Phone:406-293-8711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-20
Last Update Date:2017-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT128448363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily