Provider Demographics
NPI:1497828073
Name:EVERHART, ADAM GLENN (RN, CNOR, RNFA)
Entity Type:Individual
Prefix:MR
First Name:ADAM
Middle Name:GLENN
Last Name:EVERHART
Suffix:
Gender:M
Credentials:RN, CNOR, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6867 BERRY BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:CANFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44406-8629
Mailing Address - Country:US
Mailing Address - Phone:330-533-5984
Mailing Address - Fax:
Practice Address - Street 1:6867 BERRY BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:CANFIELD
Practice Address - State:OH
Practice Address - Zip Code:44406-8629
Practice Address - Country:US
Practice Address - Phone:330-533-5984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH190010163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant