Provider Demographics
NPI:1952043945
Name:ATKINSON, ADIYA (LPN)
Entity Type:Individual
Prefix:
First Name:ADIYA
Middle Name:
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 BROWN DR # A
Mailing Address - Street 2:
Mailing Address - City:BELMONT
Mailing Address - State:NC
Mailing Address - Zip Code:28012-4702
Mailing Address - Country:US
Mailing Address - Phone:980-327-3240
Mailing Address - Fax:
Practice Address - Street 1:4109 BROWN DR # A
Practice Address - Street 2:
Practice Address - City:BELMONT
Practice Address - State:NC
Practice Address - Zip Code:28012-4702
Practice Address - Country:US
Practice Address - Phone:980-327-3240
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-11
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY343889-01164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse