Provider Demographics
NPI:1629418181
Name:ADKINS, ELLEN SOLEY (DNP, APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:ELLEN
Middle Name:SOLEY
Last Name:ADKINS
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-BC
Other - Prefix:MISS
Other - First Name:ELLEN
Other - Middle Name:ROSE
Other - Last Name:SOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1875 HARDEN ST
Mailing Address - Street 2:THE FREE MEDICAL CLINIC
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29204-1014
Mailing Address - Country:US
Mailing Address - Phone:803-765-1503
Mailing Address - Fax:
Practice Address - Street 1:1875 HARDEN ST
Practice Address - Street 2:THE FREE MEDICAL CLINIC
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29204-1014
Practice Address - Country:US
Practice Address - Phone:803-765-1503
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2014-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC18166363LF0000X
NY8214293363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily