Provider Demographics
NPI:1790326023
Name:ADAMS, EMILY SARAH
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:SARAH
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 1:65 WALNUT ST STE 310
Mailing Address - Street 2:
Mailing Address - City:WELLESLEY
Mailing Address - State:MA
Mailing Address - Zip Code:02481-2129
Mailing Address - Country:US
Mailing Address - Phone:781-772-1527
Mailing Address - Fax:
Practice Address - Street 1:7 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02907-2201
Practice Address - Country:US
Practice Address - Phone:401-648-4700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-08
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2320455163W00000X, 363LP0200X
RI61201163W00000X
RI02216363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse