Provider Demographics
NPI:1578599452
Name:ADRIAN, MARY BETH (RN)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BETH
Last Name:ADRIAN
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 1:2002 SW 348TH STREET
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98023-3103
Mailing Address - Country:US
Mailing Address - Phone:253-874-9453
Mailing Address - Fax:
Practice Address - Street 1:1060 RAMBLING OAKS DRIVE
Practice Address - Street 2:APT 103
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072
Practice Address - Country:US
Practice Address - Phone:405-360-3146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00045100163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health