Provider Demographics
NPI:1659724623
Name:ASIAM, ADOBEA (CRNP)
Entity Type:Individual
Prefix:
First Name:ADOBEA
Middle Name:
Last Name:ASIAM
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 TOLL HOUSE AVE
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5930
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:915 TOLL HOUSE AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5930
Practice Address - Country:US
Practice Address - Phone:301-624-5390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR181033363LF0000X
PASP025106363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily