Provider Demographics
NPI:1639923022
Name:ADAMS, JO ELLEN (RN)
Entity Type:Individual
Prefix:
First Name:JO ELLEN
Middle Name:
Last Name:ADAMS
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 1:118 ELM ST
Mailing Address - Street 2:
Mailing Address - City:BONNER SPRINGS
Mailing Address - State:KS
Mailing Address - Zip Code:66012-1021
Mailing Address - Country:US
Mailing Address - Phone:407-415-2015
Mailing Address - Fax:
Practice Address - Street 1:118 ELM ST
Practice Address - Street 2:
Practice Address - City:BONNER SPRINGS
Practice Address - State:KS
Practice Address - Zip Code:66012-1021
Practice Address - Country:US
Practice Address - Phone:407-415-2015
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS13-63184163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool