Provider Demographics
NPI:1790429454
Name:ADKINS, ALEXANDRIA DANIELLE
Entity Type:Individual
Prefix:MRS
First Name:ALEXANDRIA
Middle Name:DANIELLE
Last Name:ADKINS
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 1:6815 MONROE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132-1417
Mailing Address - Country:US
Mailing Address - Phone:816-325-0737
Mailing Address - Fax:
Practice Address - Street 1:6815 MONROE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132-1417
Practice Address - Country:US
Practice Address - Phone:816-325-0737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty