Provider Demographics
NPI:1649751546
Name:ADAMS, ANDREA JADE (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:JADE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:193 BRANHAM HTS
Mailing Address - Street 2:
Mailing Address - City:PIKEVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:41501-6701
Mailing Address - Country:US
Mailing Address - Phone:606-369-3684
Mailing Address - Fax:
Practice Address - Street 1:119 RIVER DR
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-1685
Practice Address - Country:US
Practice Address - Phone:606-437-5500
Practice Address - Fax:606-433-9690
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3012508363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily