Provider Demographics
NPI:1700530797
Name:NADEAU, ADAM
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:NADEAU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1646 28TH AVE S APT 6
Mailing Address - Street 2:
Mailing Address - City:GRAND FORKS
Mailing Address - State:ND
Mailing Address - Zip Code:58201-6712
Mailing Address - Country:US
Mailing Address - Phone:701-550-9864
Mailing Address - Fax:
Practice Address - Street 1:1646 28TH AVE S APT 6
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6712
Practice Address - Country:US
Practice Address - Phone:701-550-9864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-08
Last Update Date:2022-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider