Provider Demographics
NPI:1013290501
Name:ADAMS, AMY L (LPN)
Entity Type:Individual
Prefix:MRS
First Name:AMY
Middle Name:L
Last Name:ADAMS
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 1:3932 PALISADES PARK DR
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59102-0134
Mailing Address - Country:US
Mailing Address - Phone:406-534-3090
Mailing Address - Fax:
Practice Address - Street 1:3932 PALISADES PARK DR
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-0134
Practice Address - Country:US
Practice Address - Phone:406-534-3090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT38-3851752OtherEIN