Provider Demographics
NPI:1457682825
Name:ADKINS, LAURIE MICHELLE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:MICHELLE
Last Name:ADKINS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13935 LANDSTAR BLVD STE 150
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32824-5533
Mailing Address - Country:US
Mailing Address - Phone:330-904-7377
Mailing Address - Fax:
Practice Address - Street 1:13935 LANDSTAR BLVD STE 150
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32824-5533
Practice Address - Country:US
Practice Address - Phone:216-445-4545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-24
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH363AM0700X
363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical