Provider Demographics
NPI:1417116435
Name:FLEETWOOD, ADRIANNE E (RN)
Entity Type:Individual
Prefix:MRS
First Name:ADRIANNE
Middle Name:E
Last Name:FLEETWOOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 VALLEY VIEW DR
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-3592
Mailing Address - Country:US
Mailing Address - Phone:740-366-5149
Mailing Address - Fax:
Practice Address - Street 1:19 VALLEY VIEW DR
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-3592
Practice Address - Country:US
Practice Address - Phone:740-366-5149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 267419163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse