Provider Demographics
NPI:1689813974
Name:ADAM, FRANTZIE EMMANUELLE
Entity Type:Individual
Prefix:
First Name:FRANTZIE
Middle Name:EMMANUELLE
Last Name:ADAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16515 72ND AVE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-4233
Mailing Address - Country:US
Mailing Address - Phone:347-561-3786
Mailing Address - Fax:
Practice Address - Street 1:16515 72ND AVE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-4233
Practice Address - Country:US
Practice Address - Phone:347-561-3786
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-11
Last Update Date:2010-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY568165163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse