Provider Demographics
NPI:1760249403
Name:ADAMS, MI'YONNA MASHELLE
Entity Type:Individual
Prefix:
First Name:MI'YONNA
Middle Name:MASHELLE
Last Name:ADAMS
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 1:317 BRYAN PL
Mailing Address - Street 2:
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-4534
Mailing Address - Country:US
Mailing Address - Phone:202-905-8513
Mailing Address - Fax:
Practice Address - Street 1:317 BRYAN PL
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-4534
Practice Address - Country:US
Practice Address - Phone:202-905-8513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-29
Last Update Date:2024-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide