Provider Demographics
NPI:1407503154
Name:ADAMS, BOBBIE ANN (AGNP)
Entity Type:Individual
Prefix:
First Name:BOBBIE
Middle Name:ANN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12073 TECH RD STE B
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20904-7874
Mailing Address - Country:US
Mailing Address - Phone:301-593-1315
Mailing Address - Fax:
Practice Address - Street 1:12073 TECH RD STE B
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20904-7874
Practice Address - Country:US
Practice Address - Phone:301-593-1315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-02
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP026416363LA2200X, 363LG0600X
PARN516953L163WH1000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH1000XNursing Service ProvidersRegistered NurseHospice
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology