Provider Demographics
NPI:1255737433
Name:ADAMS, MARY ANNE (RN, APN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ANNE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:RN, APN
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ANNE
Other - Last Name:CASSIANI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6139 GLENWAY AVENUE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211-6312
Mailing Address - Country:US
Mailing Address - Phone:513-346-3399
Mailing Address - Fax:513-389-0957
Practice Address - Street 1:6139 GLENWAY AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45211-6312
Practice Address - Country:US
Practice Address - Phone:513-346-3399
Practice Address - Fax:513-389-0957
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL041.287085163WE0003X
IL209.012185363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency