Provider Demographics
NPI:1780652560
Name:ADAMS, GENEVIEVE KATHLEEN (APRN)
Entity type:Individual
Prefix:MS
First Name:GENEVIEVE
Middle Name:KATHLEEN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:GENEVIEVE
Other - Middle Name:KATHLEEN
Other - Last Name:HERRMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:2425 N WOODBINE RD STE A
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3647
Mailing Address - Country:US
Mailing Address - Phone:816-676-8050
Mailing Address - Fax:
Practice Address - Street 1:2425 N WOODBINE RD STE A
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3647
Practice Address - Country:US
Practice Address - Phone:816-676-8050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS45012363LF0000X
MO124488363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO425803848Medicaid
KS100288780CMedicaid
MO124488OtherMO LICENSE
KS100362750CMedicaid
KS100362750CMedicaid
KS100362750CMedicaid
MO124488OtherMO LICENSE