Provider Demographics
NPI:1831271485
Name:ADKINS-DWIVEDI, AMY NICOLE (NP)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:NICOLE
Last Name:ADKINS-DWIVEDI
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17256 NE 18TH PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98008-3141
Mailing Address - Country:US
Mailing Address - Phone:513-257-5380
Mailing Address - Fax:
Practice Address - Street 1:8105 166TH AVE NE
Practice Address - Street 2:202
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-3999
Practice Address - Country:US
Practice Address - Phone:425-941-9540
Practice Address - Fax:425-633-2281
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2012-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN 307054163W00000X
OHNP-08943363LP0200X
WAAP60228488363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse