Provider Demographics
NPI:1841046844
Name:ADAMS, SHEA T (RN)
Entity type:Individual
Prefix:MRS
First Name:SHEA
Middle Name:T
Last Name:ADAMS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 DOUBLE EAGLE DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:38483
Mailing Address - Country:US
Mailing Address - Phone:256-412-6169
Mailing Address - Fax:
Practice Address - Street 1:1909 HAMPSHIRE PIKE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:TN
Practice Address - Zip Code:38401-5650
Practice Address - Country:US
Practice Address - Phone:931-388-5757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-29
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN186368163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice