Provider Demographics
NPI:1023061454
Name:ADAMS, IRMA (CNP)
Entity type:Individual
Prefix:
First Name:IRMA
Middle Name:
Last Name:ADAMS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 337
Mailing Address - Street 2:NEW RIVER HEALTH ASSOCIATION INC
Mailing Address - City:SCARBRO
Mailing Address - State:WV
Mailing Address - Zip Code:25917
Mailing Address - Country:US
Mailing Address - Phone:304-574-3960
Mailing Address - Fax:304-574-2971
Practice Address - Street 1:410 W MAIN STREET
Practice Address - Street 2:GULF FAMILY PRACTICE
Practice Address - City:SOPHIA
Practice Address - State:WV
Practice Address - Zip Code:25921
Practice Address - Country:US
Practice Address - Phone:304-683-4304
Practice Address - Fax:304-683-4307
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV26738163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV001834143OtherBLUE CROSS