Provider Demographics
NPI:1659670354
Name:JONES-ADAMCZYK, ADRIENNE LEE (NP)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:LEE
Last Name:JONES-ADAMCZYK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 843225
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3225
Mailing Address - Country:US
Mailing Address - Phone:813-262-8160
Mailing Address - Fax:813-891-9066
Practice Address - Street 1:3004 GORDONVILLE RD
Practice Address - Street 2:
Practice Address - City:CAPE GIRARDEAU
Practice Address - State:MO
Practice Address - Zip Code:63703-5008
Practice Address - Country:US
Practice Address - Phone:573-332-1972
Practice Address - Fax:573-334-4667
Is Sole Proprietor?:No
Enumeration Date:2011-03-21
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2010041397363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR187382758Medicaid
MO1659670354Medicaid
IL1659670354Medicaid
IL1659670354Medicaid