Provider Demographics
NPI:1710213665
Name:ADAMS, LYNNE ANNE (NP)
Entity Type:Individual
Prefix:MRS
First Name:LYNNE
Middle Name:ANNE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3554 BETTY JEAN LN
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47805-1088
Mailing Address - Country:US
Mailing Address - Phone:812-514-8125
Mailing Address - Fax:
Practice Address - Street 1:2723 S 7TH ST
Practice Address - Street 2:ST O
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47802
Practice Address - Country:US
Practice Address - Phone:812-232-1418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2018-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003102A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200966270Medicaid
INP00792416OtherRAILROAD MEDICARE
IN147180RRRMedicare PIN