Provider Demographics
NPI:1407502578
Name:ANDERSON, ADRIANNA M (PHARMD)
Entity Type:Individual
Prefix:
First Name:ADRIANNA
Middle Name:M
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10601 ELDON WILLING RD
Mailing Address - Street 2:
Mailing Address - City:DEAL ISLAND
Mailing Address - State:MD
Mailing Address - Zip Code:21821-1707
Mailing Address - Country:US
Mailing Address - Phone:443-859-1053
Mailing Address - Fax:
Practice Address - Street 1:7001 LANKFORD HWY
Practice Address - Street 2:
Practice Address - City:OAK HALL
Practice Address - State:VA
Practice Address - Zip Code:23416-2223
Practice Address - Country:US
Practice Address - Phone:757-824-4477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-26
Last Update Date:2023-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202220180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist