Provider Demographics
NPI:1962824805
Name:ADAMS, CAROLYN LEE (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:LEE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4820 WEST TAFT ROAD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088
Mailing Address - Country:US
Mailing Address - Phone:315-413-0004
Mailing Address - Fax:315-413-0827
Practice Address - Street 1:4820 WEST TAFT ROAD
Practice Address - Street 2:SUITE 108
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088
Practice Address - Country:US
Practice Address - Phone:315-413-0004
Practice Address - Fax:315-413-0827
Is Sole Proprietor?:No
Enumeration Date:2014-01-13
Last Update Date:2014-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NYF338026-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner