Provider Demographics
NPI:1740231711
Name:CAMPOS-ADKINS, ANN A (RN, FNP)
Entity Type:Individual
Prefix:MS
First Name:ANN
Middle Name:A
Last Name:CAMPOS-ADKINS
Suffix:
Gender:F
Credentials:RN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 412
Mailing Address - Street 2:
Mailing Address - City:LAWTELL
Mailing Address - State:LA
Mailing Address - Zip Code:70550-0412
Mailing Address - Country:US
Mailing Address - Phone:337-207-1873
Mailing Address - Fax:
Practice Address - Street 1:401 AUDUBON BLVD
Practice Address - Street 2:STE 102B
Practice Address - City:LAFAYETTE
Practice Address - State:LA
Practice Address - Zip Code:70503-2676
Practice Address - Country:US
Practice Address - Phone:337-237-7801
Practice Address - Fax:337-235-1865
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2009-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN036483363LF0000X
LAAP03082363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA970006411OtherRAILROAD MEDICARE
LA1694525Medicaid
LA5X233Medicare ID - Type Unspecified
LA1694525Medicaid